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2 to 16 years. From Feingold and Bossert (1974),

Middle Finger Length

Definition Total length of middle finger.

Landmarks Measure from the proximal flexion crease at the base of the middle finger to tip of the middle finger. The measurement is taken on the palmar aspect of the hand (Fig. 8.21).

Instruments Tape-measure, calipers, or clear ruler.

Position The wrist is in a neutral position and the hand is fully extended.

Alternative Draw around hand and estimate where the proximal flexion crease of the middle finger would be, then measure from the paper.

Remarks The proximal finger crease on the palmar aspect of the hand is about 1-2 cm distal to the knuckle on the dorsal aspect of the hand; therefore this measurement does not reflect the sum of the lengths of the phalanges of the middle finger. Middle finger lengths from birth to age 16 years are shown in 8.22-8.24.

Pitfalls In various forms of brachydactyly, different finger lengths will be reduced. In some forms of brachydactyly, measurement of the middle finger will not reflect the lengths of the other digits.

In individuals with contractures, work the tape along the finger in order to get a measurement equivalent to total finger length.

27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 Gestational age (weeks)

Figure 8.22 Middle finger length, both sexes, at birth. From Merlob et al. (1984), by permission.

27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 Gestational age (weeks)

Figure 8.22 Middle finger length, both sexes, at birth. From Merlob et al. (1984), by permission.

Figure 8.23(a) Middle finger length, both sexes, birth to two years. From Feingold and Bossert (1974), by permission.

Figure 8.23(b) Middle finger length, both sexes, 2 to 16 years. From Feingold and Bossert (1974), by permission.

Figure 8.23(b) Middle finger length, both sexes, 2 to 16 years. From Feingold and Bossert (1974), by permission.

Chapter 8 Limbs Palm Length

Definition Total length of the palm.

Landmarks Measure between the distal flexion crease at the wrist and the proximal flexion crease of the middle finger (Fig. 8.24).

Instruments Tape-measure, calipers, or clear ruler.

Position The wrist is in a neutral position and the fingers are fully extended. The measurement is taken on the palmar aspect of the hand.

Alternative Subtract the middle finger length from the total hand length. Draw around the hand and then measure the palm length from the drawing, estimating the position of the creases.

Remarks Palm length from birth to age 16 years are shown in Figs. 8.25 and 8.26. A ratio of middle finger to total hand lenght (Fig. 8.27) is helpful in defining relative disproportion in the hand.

Figure 8.24 Measuring palm length.

27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 Gestational age (weeks)

Figure 8.25 Palm length, both sexes, at birth. From Sivan et al. (1983), by permission.

27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 Gestational age (weeks)

Figure 8.25 Palm length, both sexes, at birth. From Sivan et al. (1983), by permission.

Figure 8.26 Palm length, both sexes, birth to 16 years. From Feingold and Bossert (1974), by permission.

Figure 8.26 Palm length, both sexes, birth to 16 years. From Feingold and Bossert (1974), by permission.

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