ABSTRACT
Typically, abnormalities of the hand are only noted as part of a careful fetal survey after the diagnosis of another abnormality. Under these circumstances, the hand abnormalities are likely to be related to the chromosomal or genetic abnormality diagnosed. The presence of overlapping fingers or a clenched hand is suggestive of a chromosomal disorder such as trisomy 18 or a neuromuscular disorder such as Pena–Shokeir sequence. Polydactyly is a common isolated finding with an excellent prognosis. Associated features suggest a diagnosis such as a trisomy, skeletal dysplasia, Meckel-–Gruber, and Smith-–Lemli-–Opitz syndromes. Missing or prematurely foreshortened digits are characteristic of amniotic band syndrome and terminal transverse limb defects. A split-hand or ‘lobster-claw’ deformity is suggestive of ectrodactyly.
