{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T13:15:46Z","timestamp":1776777346927,"version":"3.51.2"},"reference-count":20,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,9,21]],"date-time":"2023-09-21T00:00:00Z","timestamp":1695254400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Department of Anatomy, Medical School, University of P\u00e9cs"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Syndactyly is the most common congenital malformation of the hand, leading to the fusion of the digits and frequently affecting the ring and middle fingers. The incidence is 1 out of 2500 children, predominantly occurring in boys and Caucasians. Clinically, the malformation may present as a soft tissue or bony fusion, resulting in the union of the fingers characterised as complete or incomplete. This fusion may involve the phalanges but may also extend to the carpal\/tarsal bones, even to the metacarpal or metatarsal level, rarely to the distal end of the forearm and lower leg. The malformation is mostly isolated but may occur together with other disorders or malformations such as synostosis, acro-syndactyly, cleft hand, clinodactyly, or polydactyly. Syndromic syndactyly can be observed in cases of Apert syndrome, Poland\u2019s syndrome, Pfeiffer syndrome, and many others. A girl born in June of 2019 was diagnosed with congenital malformation of the right hand at birth\u2014affecting the right middle, ring, and little fingers, respectively. After X-ray imaging, the fusion of the third and fourth proximal phalanges to a common metacarpal was identified, forming a unique diagnosis of clino-syndactyly with metacarpal aplasia. Surgical intervention was advocated for, including a wedge osteotomy to correct the synchondrosis at the phalangeal base and a dorsal flap to close the interdigital space created during the correction of the III and IV. fingers. A trapezoid flap for the release of the syndactyly of the IV and V. fingers was applied. The paper aims to present this surgical correction and its results regarding an atypical case of syndactyly with clinodactyly and metacarpal aplasia.<\/jats:p>","DOI":"10.3390\/life13091943","type":"journal-article","created":{"date-parts":[[2023,9,21]],"date-time":"2023-09-21T04:53:05Z","timestamp":1695271985000},"page":"1943","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A Complex Case of Clino-Syndactyly with Fourth Metacarpal Aplasia"],"prefix":"10.3390","volume":"13","author":[{"given":"Hermann","family":"Nudelman","sequence":"first","affiliation":[{"name":"Department of Paediatrics, Clinical Complex, Division of Surgery, Traumatology and Otorhinolaryngology, University of P\u00e9cs, 7 J\u00f3zsef Attila Street, 7623 P\u00e9cs, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6705-3292","authenticated-orcid":false,"given":"Aba","family":"L\u0151rincz","sequence":"additional","affiliation":[{"name":"Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of P\u00e9cs, 12 Szigeti Street, 7624 P\u00e9cs, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7748-6729","authenticated-orcid":false,"given":"Anna Gabriella","family":"Lamberti","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Clinical Complex, Division of Surgery, Traumatology and Otorhinolaryngology, University of P\u00e9cs, 7 J\u00f3zsef Attila Street, 7623 P\u00e9cs, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tam\u00e1s","family":"Kassai","sequence":"additional","affiliation":[{"name":"Department of Pediatric Traumatology, P\u00e9terfy Hospital, Manninger Jen\u0151 National Trauma Center, 17 Fiumei Street, 1081 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3348-5385","authenticated-orcid":false,"given":"Gerg\u0151","family":"J\u00f3zsa","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Clinical Complex, Division of Surgery, Traumatology and Otorhinolaryngology, University of P\u00e9cs, 7 J\u00f3zsef Attila Street, 7623 P\u00e9cs, Hungary"},{"name":"Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of P\u00e9cs, 12 Szigeti Street, 7624 P\u00e9cs, Hungary"},{"name":"Department of Anatomy, Medical School, University of P\u00e9cs, 12 Szigeti Street, 7624 P\u00e9cs, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,21]]},"reference":[{"key":"ref_1","first-page":"e36118","article-title":"Syndactyly in the Pediatric Population: A Review of the Literature","volume":"15","author":"Mahindroo","year":"2023","journal-title":"Cureus"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1038\/ejhg.2012.14","article-title":"Syndactyly: Phenotypes, Genetics and Current Classification","volume":"20","author":"Malik","year":"2012","journal-title":"Eur. J. Hum. Genet."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Zaib, T., Rashid, H., Khan, H., Zhou, X., and Sun, P. (2022). Recent Advances in Syndactyly: Basis, Current Status and Future Perspectives. Genes, 13.","DOI":"10.3390\/genes13050771"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1186\/s13023-022-02339-0","article-title":"Genetic Determinants of Syndactyly: Perspectives on Pathogenesis and Diagnosis","volume":"17","author":"Cassim","year":"2022","journal-title":"Orphanet J. Rare Dis."},{"key":"ref_5","first-page":"903","article-title":"A case-control study on genetic and environmental factors regarding polydactyly and syndactyly","volume":"30","author":"Luo","year":"2009","journal-title":"Zhonghua Liu Xing Bing Xue Za Zhi"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1097\/01.prs.0000194904.81981.71","article-title":"Maternal Cigarette Smoking during Pregnancy Increases the Risk of Having a Child with a Congenital Digital Anomaly","volume":"117","author":"Man","year":"2006","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1055\/s-0036-1593478","article-title":"Syndactyly Release","volume":"30","author":"Braun","year":"2016","journal-title":"Semin. Plast. Surg."},{"key":"ref_8","first-page":"3","article-title":"The Operative Incidence of Syndactyly in Northern Ireland. A 10-Year Review","volume":"90","author":"McGarry","year":"2021","journal-title":"Ulster Med. J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/0266-7681_87_90184-7","article-title":"Clinodactyly of the Little Finger: A Simple Operative Technique for Reversal of the Growth Abnormality","volume":"12","author":"Vickers","year":"1987","journal-title":"J. Hand Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1177\/1558944719828003","article-title":"National Patterns in Surgical Management of Syndactyly: A Review of 956 Cases","volume":"15","author":"Chouairi","year":"2020","journal-title":"Hand"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/S0072-968X(79)80049-2","article-title":"Clinodactyly. A Review of a Series of Cases","volume":"11","author":"Burke","year":"1979","journal-title":"Hand"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Laub, D.R. (2015). Congenital Anomalies of the Upper Extremity: Etiology and Management, Springer.","DOI":"10.1007\/978-1-4899-7504-1"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1080\/08998280.2005.11928094","article-title":"The Troubles with Pinkies","volume":"18","author":"Flatt","year":"2005","journal-title":"Proc. Bayl. Univ. Med. Cent."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/S0363-5023(98)80082-8","article-title":"Camptodactyly: A Unifying Theory and Approach to Surgical Treatment","volume":"23","author":"Smith","year":"1998","journal-title":"J. Hand Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1897","DOI":"10.1097\/01.prs.0000218977.46520.55","article-title":"Camptodactyly as a Spectrum of Congenital Deficiencies: A Treatment Algorithm Based on Clinical Examination","volume":"117","author":"Foucher","year":"2006","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1016\/j.jhsa.2009.01.007","article-title":"Closing Wedge Osteotomy of Abnormal Middle Phalanx for Clinodactyly","volume":"34","author":"Ali","year":"2009","journal-title":"J. Hand Surg."},{"key":"ref_17","first-page":"525","article-title":"Camptodactyly and clinodactyly\u2014New understanding of known deformities","volume":"60","author":"Lamot","year":"2021","journal-title":"Acta Clin. Croat."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1177\/1558944719827999","article-title":"Comparison of Vickers\u2019 Physiolysis With Osteotomy for Primary Correction of Clinodactyly","volume":"15","author":"Gillis","year":"2020","journal-title":"Hand"},{"key":"ref_19","first-page":"642","article-title":"Bilobed Flap in Hand Clinodactyly Reconstruction: Technique Description and Result Appraisal","volume":"57","author":"Kaempf","year":"2021","journal-title":"Rev. Bras. Ortop."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1016\/j.jhsa.2015.01.017","article-title":"Outcomes of Opening Wedge Osteotomy to Correct Angular Deformity in Small Finger Clinodactyly","volume":"40","author":"Piper","year":"2015","journal-title":"J. Hand Surg."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/13\/9\/1943\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:54:40Z","timestamp":1760129680000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/13\/9\/1943"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,21]]},"references-count":20,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,9]]}},"alternative-id":["life13091943"],"URL":"https:\/\/doi.org\/10.3390\/life13091943","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,21]]}}}