An Isolated Case of Brachyphalangism of the Basal Finger Bones of the Little Finger with Symptoms of Tenosynovitis: A Case Report

Brachydactyly is a general term characterized by disproportionately short fingers and toes. It can occur as an isolated finding or as part of a complex syndrome. The signs of brachydactyly are usually present at birth, but it’s possible that shortened limbs become more obvious with growth and development. The main symptom of brachydactyly is fingers, toes, or both that are shorter than normal. And unless there is an accompanying disorder that produces symptoms, or the shortened digits impair the use of hands and feet, there is no treatment needed for brachydactyly.

In fact, brachydactyly is an inherited condition, which makes genetics the main cause. And it is usually classified as types A, B, C, D, or E; brachymetatarsus IV; Sugarman brachydactyly; or Kirner deformity. Various types of isolated brachydactyly are rare, except for types A3 and D. And it is often difficult to confirm the diagnosis, yet this is important as the treatment varies in accordance with the type of treatment.

In this paper, the authors described a case report of a 15-year-old girl. She presented with developing pain and snapping in the left little finger for 1 year prior to the consultation. She had no previous medical history or traumatic history. Her little finger length was almost equal to the proximal interphalangeal (PIP) joint level of the adjacent ring finger. And the doctors also observed tenderness and snapping around the PIP joint of the finger. Finally, the doctors diagnosed tenosynovitis at the A3 pulley accompanied by brachyphalangism and then performed surgery. The removed cord-like scar tissue seemed to be scarred vincula. There was no recurrence of the symptoms 1 year postoperatively.

In short, tenosynovitis might be caused by growth deviation between the flexor digitorum superficialis and the flexor digitorum profundus. All hand surgeons should keep in mind that isolated brachydactyly might develop tenosynovitis-like symptoms.

Article by Kazuhiko Hashimoto, et al, from Osakasayama City, Osaka, Japan.

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