BRACHYDACTYLY.
Undue shortness of the fingers or toes may occur either as a congenital or as an acquired defect. The congenital form, due to imperfect formation of any or all of the bony elements of a digit (including the metacarpal bone), is insusceptible of treatment except by amputation, should that step be justified by the inconvenience or deformity attached to the defective member.
Acquired brachydactyly may arise in several ways. Occasionally it is to be traced to an arrest of development either due to an injury during childhood or adolescence, or without apparent explanation, but more frequently it is a result of disease. In younger subjects the most common cause is the destruction of bone in tuberculous disease, which may practically eliminate a phalanx, leaving the rest healthy. In older people it may be met with in cases of perforating ulcer, the proximal phalanx of the great toe and sometimes other bones undergoing a slow and painless disintegration, which is manifested chiefly by a progressive shortening of the digit with few or none of the more obvious signs of caries.
FOOTNOTES
[1] “Les doigts, et particulièrement les trois derniers, sont sujets à une flexion permanent involontaire; à laquelle on a donné le nom de ‘contracture,’ et que quelques auteurs out appelée en latin ‘crispatura tendinum.’” This name is usually attributed to Boyer himself. (“Maladies Chirurgicales,” vol. ii. p. 55, first edition, 1826).
[2] See “The Hand as a Diagnostic Factor in Diseases of the Nervous System” (Long-Fox: Med. Annual, 1891, p. 54).
[3] Transactions of the College of Physicians, 1895, p. 67.
[4] Therapeutic Gazette, February 15, 1892.
[5] Ibid. October 16, 1893.
[6] Brit. Med. Journal, 1888, vol. i. p. 961.