A case of the Symphalangism Cushing Yoshio Takeda*, Fumio Kikkawa An eighteen-year-old boy of Japanese clinically and roentgenographically examined, h

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1 A case of the Symphalangism Cushing Yoshio Takeda*, Fumio Kikkawa An eighteen-year-old boy of Japanese clinically and roentgenographically examined, has striking abnormalities in hands and feet. There are no dorsal transverse wrinkles at the distal interphalangeal joint areas of 2nd, 3rd, 4th and 5th fingers of both hands and at the proximal interphalangeal joint area of 5th finger of left hand. Volar creases are not found also at the distal interphalangeal joint areas of 2nd, 3rd and 4th fingers of both hands. X-ray examination has revealed that the joint cavities of the affected joints are narrow (Synchondrosis) and the Range of Motion (ROM) are also limited. At the proximal and distal interphalangeal joint areas of all toes of both feet, there aren't transverse wrinkles. The proximal interphalangeal joints of 4th and 5th toes of left feet and the distal interphalangeal joints of 5th toes of both sides showed the Synchondrosis by X-ray examination. Limitation of the RUM is observed at the distal interphalangeal joint flexion of the 1st, 2nd and 3rd toes of both sides and proximal interphalangeal joint flexion of the 4th toes of both feet. Analysis of chromosome of the leucocytes in peripheral blood shows normality. Existence of the heredity in this family was not definite, but the patient told us that behavier of his father and cousins showed to be Symphalangism. Key words: Symphalangism Cushing, Phalangeal anomaly Present address*: Reformatory of Odawara, Ohgi-cho, Odawara, Kanagawa Pra., 250 Japan

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22) Harle, T.S., and Stevenson, Cap. J.R.: Hereditary symphalangism associated with carpal and tarsal fusions. Radiology, 89, 91 `94, 1967. 23) Kassner, E.G., Katz, I., and Qazi, Q.H.: Sympha- langism with metacarpophlangeal fusions and elbow abnormalities.

7 22) Harle, T.S., and Stevenson, Cap. J.R.: Hereditary symphalangism associated with carpal and tarsal fusions. Radiology, 89, 91 `94, ) Kassner, E.G., Katz, I., and Qazi, Q.H.: Sympha- langism with metacarpophlangeal fusions and elbow abnormalities. Pediat. Radiol., 4, 103 `407, ) Maroteaux, P., Bouvet, J.P., and Briard, M.L. La maladie des synostoses multiples. Nouv. Presse Med., 16, 3041 `3047, ) Dellon, A.L., and Gaylor, R.: Bilateral symphala- ngism of the index finger. J. Bone Joint Surg., 58, 270 `271, ) Calvert, J.P.: A case of symphalangism associated with carpal and tarsal fusions. Hand, 6, 291 `294, ) Flatt, A.E., and Wood, V.E.: Rigid digits or symphalangism Hand, 7, 197 `214, ) Baschek, V.: Stapes fixation and proximal sym- phalangism caused by autosomal dominant trans- mission: Laryngol. Rhinol. Otol., 57, 299 `304, ) Rosseger, H., Wendler, H., and Nika, W.: Here- 16) Strasburger, A.K. Hawkins, M.R., Eldrige, R. ditary symphalangism; observations on this syndrome in a newborn infant and his mother. Wien Klin. Wochenschr., 86, 564 `567, Hardrave, R.L. and McKusick, V.A.: Symphalamgism; genetic and clinical aspects. Bull. Johns Hopk. Hosp., 117, 108 `427, Comings, D.E.: Symphalangism and fourth digit 17) hypophalangism. Arch. Intern. Med., 115, 580 `583, Elkington, and Huntsman, R.G.: The talbot 18) S.G., fingers. study in symphalangism. Med. J., A Br. 1, 407 `411, Fuhrmann, W., 19) Steffens, C., Schwarz, G., and Wagner, Dominant erbliche Brachydaktylie mit A.: Gelenkdysplasien. Humangenetik, 1, 337 `353, ) Geelhoed, G., Neel, J.V., and Davidson, R.T.: Symphalangism and tarsal coalitions; a hereditary syndrome. report on two families. J. Bone Joint A Surg., 278 `279, B, 21) Gorlin, R.J., Kietzen, G., and Wolfson, J.: Stapes fixation and proximal symphalangism. Kinderbeak., Z. 108, 12 `16, 1970.

Table 2 Cases of Nail Deformity Associated with upward Distortion of Distal Soft Tissue No. Age Sex Affected RegionsDuration Results M Both grea

Table 2 Cases of Nail Deformity Associated with upward Distortion of Distal Soft Tissue No. Age Sex Affected RegionsDuration Results 1. 49 M Both great toes 2 years Cured after 4 months 2. 11 F Both great