Triphalangeal Thumb

TPT Triphalangeal Thumb

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Note what signs you see.

I (W. Wertelecki, M.D.) see a dysmorphic right thumb, probably triphalangeal (TPT) or finger-like. As shown here TPT usually is associated with hypoplastic thenar musculature. The area of the first toes may be affected. ALL INSTANCES MUST BE SUSPECT OF REPRESENTING THE HOLT-ORAM syndrome, which is an association of TPT with cardiac malformations.

PERSPECTIVE: This patient was referred to due to “hyperelasticity” (presumably referring to the hypermobility of the thumbs), the left thumb seems impacted but less so than the right.

TPT often is inherited as a dominant trait expressed uni- or bilaterally. Often there are associated other anomalies from the scapula to the digits. All component of the upper and lower limbs may be impacted. Polydactyly (preaxial) is common (see short video).