What is the diagnosis and treatment for Split Hand Foot Malformation (SHFM)?

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Last updated: March 16, 2025View editorial policy

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Differential Diagnosis for Split Hand

  • Single most likely diagnosis
    • Split-hand/split-foot malformation (SHFM): This is a congenital disorder characterized by the absence or underdevelopment of central digits of the hand or foot, giving the appearance of a "split" hand. It is the most direct match for the symptoms described.
  • Other Likely diagnoses
    • Ectrodactyly: A congenital anomaly where all or part of one or more fingers or toes are missing, often presenting with a split-hand appearance. It can occur in isolation or as part of a syndrome.
    • Cleft hand: A rare congenital deformity of the hand where the hand is split, often accompanied by the absence of one or more central fingers. It's a condition that could be considered under the broader category of split-hand malformations.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Amniotic band syndrome: Although less common, this condition occurs when the inner layer of the placenta (amnion) tears without injury to the outer layer (chorion), and the amnion folds back and entwines the fetus, potentially causing limb deformities, including a split-hand appearance. Missing this diagnosis could lead to overlooking other potential complications associated with the syndrome.
    • In utero vascular disruptions: These are rare events that can cause a variety of malformations, including limb abnormalities that might resemble a split hand. Identifying this as a cause is crucial for genetic counseling and potential management of associated conditions.
  • Rare diagnoses
    • Adams-Oliver syndrome: A rare genetic disorder characterized by congenital limb abnormalities, including split-hand/split-foot malformation, and aplasia cutis congenita (absence of a portion of the skin). It's a rare condition but should be considered in the differential diagnosis due to its distinct features.
    • Poland syndrome: Characterized by underdevelopment or absence of the chest muscle (pectoralis major) on one side of the body and webbing of the fingers of the hand on the same side. While not primarily known for causing split-hand malformations, it can involve hand abnormalities and should be considered in a broad differential diagnosis.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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