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Correspondence to Dr Muhammad Javaid Hameed Rahmani, [email protected]
Background
Split hand/split foot malformation (SHFM) is a rare congenital condition that results in variable levels of developmental hypoplasia or aplasia of the distal hands and/or feet.
Case presentation
A 94-year-old woman admitted with confusion due to a urinary tract infection was seen to have significant malformation of her hands and feet. Her presentation was consistent with SHFM) or ectrodactyly. Her defects were largely symmetrical with each limb showing slight variations that were confirmed radiologically. Her hands are shown in (figures 1 and 2) and her feet are shown in (figure 3). She was otherwise physically well with no syndromic features. There were no reports of SHFM in her siblings, parents, son or three grandchildren.
Investigations
Radiographs of both hands and feet were performed to assess the skeletal structure (figures 4 and 5).
Treatment
Reconstructive surgery is an option for applicable candidates with SHFM. Prosthetics may also be available to improve activities of daily living and aesthetic appearance. The degree of disability will depend on the severity of the phenotype, but in this case her deformity had not affected her ability to live independently. Where relevant, genetic counselling is of benefit for patients planning to have children. Our patient had reported that no genetic testing or investigations had ever been carried regarding this condition.
Outcome and follow-up
She had...