Kirner's deformity of the fifth finger
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A 9-year-old girl was admitted to the hospital with her parents for treatment of little finger deformity of her right hand. She complained about the curvature and deformity of the distal phalanx of right fifth finger. One of her uncles suffered from the same deformity. The patient had no history of fracture, burn, freezing injury, or infectious disease. The clinical manifestations included the palmo-radial curvature of the distal phalanx of the right little finger without significant tenderness. The radiograph showed volar-radial angular deformity of distal phalanges of her fifth finger, wider and thicker growth plate of the distal phalanx in the form of L-physis. Laboratory examinations showed no increase in leukocytes, erythrocyte sedimentation rate (ESR), and C-reactive protein, while MRI of fingers revealed a slightly widened epiphyseal plate of the distal phalanx of the right little finger, L-shaped physis in the epiphysis, and normally inserted flexor digitorum profundus tendon. No abnormal or enhanced signal was spotted from soft issues even after a higher dose was administered.

According to the typical physical examination manifestations and imaging findings, we diagnosed it as Kirner's deformity of the fifth finger. The author recommended that patients should be hospitalized for further operative treatment. They provided 2 operation choices, one was wedge osteotomy of the distal phalanx to correct the mechanical line of the distal phalanx and fixation with Kirschner wire, and the other one is cut-off of deep flexor tendon insertion with brace immobilization. However, the patient and her guardians refused recommendations and were discharged home, because they thought this type of deformity did not affect the daily activities, similar to that her uncle experienced. In the subsequent visits, totally lasting 19 months since her first visit, have not found any change in the finger shape, range of the deformed finger, and the ability in daily activities.

Source: https://journals.lww.com/md-journal/Fulltext/2020/09250/Kirner_s_deformity_of_the_fifth_finger__A_case.35.aspx
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