What is deformity?
Deformity means a shape other than the normal. This may be an abnormality from the normal in the general population or a change from that patient's normal position. Some deformities occur due to congenital problems i.e. are present at birth. Many others occur due to wear and tear problems and others due to injury. They may or may not be associated with other symptoms such as pain, stiffness or weakness. In essence anything in the hand that looks abnormal to a patient can rightly be considered a deformity.
The deformities can be classified as: a change in shape but no change in size; an increase in size; and a decrease in size. (There may well be some cross-over between these).
A change in shape but no change in size: This usually implies an underlying structural abnormality such as a fracture (break of a bone) or a contracture most commonly Dupuytren's disease (see information sheet), but it can be congenital or developmental (not present at birth but occurring during growth).
An increase in size: This usually implies a growth. Mostly they will be of the soft tissues either a cyst (ganglion) or a solid lump (see information sheets) but they can be bony.
A decrease in size: This usually implies wasting of soft tissues. It may be due to generalised disuse such as after an injury or perhaps a stroke. Commonly it implies muscle wasting due to a nerve problem typically carpal tunnel syndrome or ulnar nerve entrapment (see information sheets).
Synovioma - benign finger growth
Why does it occur?
The pathology i.e. underlying abnormality depends upon the condition as described above.
What happens if nothing is done?
(This is referred to as the natural history i.e. what happens if Nature runs its own course.) This depends upon the diagnosis.
A change in shape but no change in size: If this is due to a bony problem it will probably not change as it is most commonly due to a fracture healed with displacement. If it is due to contracture this may be progressive like Dupuytren's disease or static such as contracture following injury which usually settle out over a few months. Developmental and congenital deformities may progress during growth.
An increase in size: This usually implies a growth. Mostly they will be of the soft tissues either a cyst (ganglion) or a solid lump (see information sheets) but they can be bony. Solid lumps almost always continue to grow, but cysts may settle in part or completely (see information sheets).
2 web syndactyly - fingers stuck together