A Child With Longitudinal Cleavage of the Upper Extremity: Treatment and Etiology Considerations

Congenital longitudinal cleavage of the forearm

“…As no structures were duplicated, the anomaly does not belong to the spectrum of mirror hand. Several classification schemes for cleft hand exist, but none of these describe proximal involvement other than radio-ulnar synostosis (Al-Qattan, 2014;Shah et al, 2010). In the OMT-classification, this anomaly could be characterized as malformation-entire limb-unspecified axis (IA4), but it does not exactly fit any existing sub-classification (Tonkin et al, 2013).The presentation of this rare upper extremity anomaly is a forearm cleavage, less severe than the previously described case of total upper extremity cleavage described by Shah et al (2010), but more severe than a conventional cleft hand.…”

“…We are aware of one previous report of total longitudinal upper extremity cleavage (Shah et al., 2010). This rare anomaly was considered to represent a proximal manifestation of cleft hand complex with early limb bud cleavage affecting the apical ectodermal ridge and mesoderm (Shah et al., 2010). In this case, the family history was also negative for other orthopaedic abnormalities.…”

Late osteomyelitis and abscess formation of the ulna after high-voltage electrical injuries: review of literature and case report

“…We are aware of one previous report of total longitudinal upper extremity cleavage (Shah et al, 2010). This rare anomaly was considered to represent a proximal manifestation of cleft hand complex with early limb bud cleavage affecting the apical ectodermal ridge and mesoderm (Shah et al, 2010).…”

“…As no structures were duplicated, the anomaly does not belong to the spectrum of mirror hand. Several classification schemes for cleft hand exist, but none of these describe proximal involvement other than radio-ulnar synostosis (Al-Qattan, 2014;Shah et al, 2010). In the OMT-classification, this anomaly could be characterized as malformation-entire limb-unspecified axis (IA4), but it does not exactly fit any existing sub-classification (Tonkin et al, 2013).The presentation of this rare upper extremity anomaly is a forearm cleavage, less severe than the previously described case of total upper extremity cleavage described by Shah et al (2010), but more severe than a conventional cleft hand.…”