Little fingers, little problems!

There are three common conditions which affect the little finger, and sometimes present to the hand clinic with symptoms:

Camptodactyly
Camptodactyly is a word derived from the Greek language, meaning ‘bent finger. It is a genetic condition, and is fairly common in Fife. Most patients know all about it when they present, because often one of their parents and grandparents has the condition. The condition produces a bend of the middle finger joint, which prevents the finger straightening but does not prevent it bending.

What symptoms can it give?
Camptodactyly is not painful, but can be a nuisance if it is severe. It is usually evident early in childhood, but may become more prominent during adolescence. The reason for this is not known for certain, but when bones are going through a growth spurt, soft tissues including the tendons have to keep up with the bone. This may cause a temporary increase in the bend on the finger, and may then cause concern.

What is the natural history?
Camptodactyly never resolves, but neither does it particularly deteriorate with time. It generally stays much the same over a lifetime.

Is treatment required?
It is very unusual for this condition to need any treatment. If the contracture is increasing then a period of splinting may be recommended to try and correct this. Surgery to correct the deformity carries a higher risk to the finger than leaving the deformity alone, and is therefore not recommended. If the contracture is very severe and interfering with function, then a fusion fo the joint can be performed.

Clinodactyly
Clinodactyly is another type of bent little finger. This time, the deformity usually arises from the middle phalanx, often from a problem related to the growth of the bone, with one side growing faster than the other. Again, this is a genetic disorder and most patients have a parent and grandparent with the condition.

What symptoms can it give?
The main symptom is the mild deformity that it causes. Occasionally people present with pain from the finger, but this settles with time, and the condition is not painful in the long-term. The deformity can be a bit of a nuisance, but the finger usually bends normally into a fist.

What is the natural history?
Clinodactyly can become more prominent during period of growth. Once adulthood is reached, the condition stays the same with no long term risk to the finger.

Is treatment required?
Treatment is not required for this deformity. Although there are operations described to correct the deformity, they are fiddly and carry a risk of complication which is not worth taking. The best advice for patients with this condition is to live with the problem. It does not get worse, and does not carry any risk.

Kirner’s Deformity
Kirner’s syndrome is a rare deformity with an unknown cause. It is characterised by increased curvature of the end bone in the little finger and usually presents after the age of 5 years.

What symptoms can it give?
Again, deformity is the primary symptom, It rarely becomes severe enough to interfere with function.

Is treatment required?
Treatment for Kirner’s syndrome is not required. The deformity is permanent, but having a surgeon attempt to correct the deformity carries a risk far higher than having the condition itself, which carries no risk.

© Fife Hand Service 2021

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