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Mirror Hand DeformityA Report of Two Cases
Mona I. Winge, MD1; Kjell Bye, MD1
1 Department of Orthopaedic Surgery, Rikshospitalet, Oslo University Hospital, Sognsvannsveien 20, 0027 Oslo, Norway. E-mail address for M.I. Winge: mwinge@ous-hf.no
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Investigation performed at the Department of Orthopaedic Surgery, Rikshospitalet, Oslo University Hospital, Oslo, Norway



Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
JBJS Case Connector, 2013 Dec 11;3(4):e127 1-4. doi: 10.2106/JBJS.CC.M.00150
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Extract

Mirror hand (ulnar dimelia) is an extremely rare congenital deformity in the upper extremity; only approximately seventy cases have been reported in the literature1,2 since the anomaly was first described in 1587 by Rueff3. The typical deformity consists of an absent radius, a duplication of the ulna, and polydactyly4,5. The elbow is generally stiff in extension, and the wrist is hyperflexed. The shoulder can be affected with instability and underdeveloped musculature1,6. The main functional problems that need to be resolved are the stiff elbow and the polydactylous hand. A resection of the olecranon process of one of the ulnae (usually the lateral “radial” one) is advised in order for the elbow7 to have improved flexion and pronation and supination. Early arthrolysis of the elbow joint has also been described8. For pollicization, the most normal finger is chosen to create a thumb9, and extensor tendons from the removed digits can be transferred to strengthen the new thumb7. We describe two patients who presented with mirror hand deformity. The patients and their parents were informed that data concerning their cases would be submitted for publication, and they provided consent.
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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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