A rare variant of mirror hand deformity

Abstract

Congenital hand and forearm anomalies pose a unique challenge in plastic and pediatric surgery. We present a case report of an 8-months-old girl with a congenital left sided hand and forearm anomaly, provisionally diagnosed as atypical left mirror hand anomaly. Classically there is absence of radius and duplication of ulna; however, our case had normal radius and ulna and a hand with seven digits arranged in two groups. We did a surgery which involved a ray amputation of the finger ulnar to the most radial digit, aiming to preserve an adequate first web space to reconstruct the thumb. The result of the surgical treatment in both functional and cosmetic aspects was, in authors' opinion, good.

Keywords: mirror hand; pollicisation; ulnar dimelia.

Figure 1

Photographs preoperatively, showing the asymmetrical mirror hand with seven digits arranged in two groups.

Figure 2

Anteroposterior radiograph of the left wrist, showing one radius and one ulna, the wrist has two ossification centers, the hand bears six triphalangeal digits with six corresponding metacarpals arranged in two groups; there is also rudimentary finger that contains only two bones.

Figure 3

Photographs of the hand after surgery immediately.

Figure 4

Photographs of the hand 5 months after pollicisation showing normal functiong hand.