FF: Camptodactyly or Clinodactyly?

Anatomy Def: Camptodactyly is a condition wherein one or more fingers are permanently bent; the little finger is always affected.

Outlander Def: Steeped in post-coital bliss (Voyager), Claire reflects on her crooked pinky finger, informing Jamie, it is a genetic gift from her mum that she passed onto Bree (see below).

Learn about the pinky finger (5th digit) in Anatomy Lesson #23, Harming Hands – Helping Hands – Healing Hands. Warning! This is a very long lesson because, well, because the hands are anatomically very complicated!

I wager book readers forgot about Claire’s crooked pinky finger – I did! 😜 A follower on Twitter reminded me just days ago! So, here goes:

Humans typically have five digits on each hand.  But, naming these appendages presents a dilemma: 🤔

    • US anatomists name a thumb and four fingers (index is #1 – pinky is #4).
    • Some European anatomists consider the thumb to be a finger (thumb is #1 – pinky is #5).

Ergo, how many fingers does a hand usually have? Clearly, the answer depends on who does the counting!

Stating the obvious, it is safest, especially in a medical setting, not use the term, “finger.” Instead, name the appendages “digits” and sequentially number them as digit #1 (thumb) through digit #5 (pinky).

Hand surgeons who helped teach my gross anatomy course didn’t use any numbers when preparing a patient for surgery to avoid mixups and mistaken surgeries! 😱 Rather, they used thumb, index, middle, ring, and little.

Now, for some quick anatomy:  The little finger (plus index, middle, and ring fingers) has three bones (phalanges). Each adjacent pair of phalanges meet at an interphalangeal (IP) joint. The IP joint nearest the wrist is the proximal interphalangeal joint (PIP); the one furtherest from the wrist is the distal interphalangeal joint (DIP).

The thumb is different because it has only two phalanges and one IP joint. Hence, US anatomists don’t consider the thumb to be a finger because of these anatomic differences.

Try This: Find the PIP and DIP joints on your index, middle, ring and little fingers. Find the IP joint on your thumb. Got it? Yay! 👍🏻

As mentioned above, camptodactyly always involves the 5th digit (pinky finger) which is permanently flexed at the  PIP joint (see image, below)!

Claire’s mother had the crooked little finger, Claire has it, and her daughter has it, too. This is not surprising as the gene for camptodactyly may be passed to the next generation by either parent.  If a person carries the gene, it may be expressed in one hand, both hands or neither.

And, if the permanent flexion is 30º or less, the hand usually functions normally.

Just to throw a monkey wrench into the issue….. Claire may have had a different condition known as clinodactyly (Greek: to bend + finger), another inheritable trait involving a crooked 5th digit.

However, clinodactyly is characterized by the pinky finger bending toward the adjacent ring finger. Yet another difference between the two conditions is that clinodactyly may occur at the DIP joint or the PIP joint, or both!

Because Claire became a skilled surgeon, we can safely assume that no matter which condition she had, the crooked right little finger did not create a hinderance to her handiwork!

Clinodactyly of the hand.
Clinodactyly is a congenital trait that is present at birth. It can occur on its own or as part of a genetic syndrome.

See: Claire’s right little finger in Outlander episode 306, A. Malcolm. The episode does not include Claire’s musing about her crooked pinky finger for good reason: It would be difficult to display such a condition throughout all seasons of Outlander!

Read: But Claire does acknowledge her finger to Jamie in Voyager book.

“Her nails are like yours; square, not oval like mine. But she has the crooked little finger on her right hand that I have,” I said, lifting it. “My mother had it, too; Uncle Lambert told me.” My own mother had died when I was five. I had no clear memory of her, but thought of her whenever I saw my own hand unexpectedly, caught in a moment of grace like this one. I laid the hand with the crooked finger on his, then lifted it to his face. 

Which condition did Claire have – camptodactyly or clinodactyly? Only Herself knows for sure! 😉

The deeply grateful,

Outlander Anatomist

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Photo and Video Credits: Sony/Starz; www.congenitalhand.wustl.edu; www.healthline.com

 

 

Fun Fact: Metacarpals

image of a woman's hands

Anatomy def: Metacarpals are one of 5 bones of the hand, situated between wrist and digits. Comparable bones of the foot are metatarsals.

Outlander def: Hand bones on which BJ plays snap, crackle, and pop! Or, was it knick knack paddy-whack, break the puir lad’s bones? Gah!

Learn the five metacarpals in Anatomy Lesson #22, Jamie’s Hand – Symbol of Sacrifice. Metacarpals are numbered 1-5 beginning with the thumb side. Together, five metacarpals form the bony skeleton in the palm of hand!

Read about metacarpals in Outlander book. But, of course, they are there! …Claire muses about metacarpals and Crainesmuir village while riding her pony behind Dougal!

In fact, I had amused myself on the ride to the smithy by imagining an aerial view of the village as a representation of a skeletal forearm and hand; the High Street was the radius, along which lay the shops and businesses and the residences of the more well-to-do. St. Margaret’s Lane was the ulna, a narrower street running parallel with the High, tenanted by smithy, tannery, and the less genteel artisans and businesses. The village square (which, like all village squares I had ever seen, was not square at all, but roughly oblong) formed the carpals and metacarpals of the hand, while the several lanes of cottages made up the phalangeal joints of the fingers.

See Claire massage the healing metacarpals of Jamie’s left hand during opening credits of S.2!

A deeply grateful,

Outlander Anatomist

 

Fun Fact: phalanges

ep 202 phalanges

sing. noun: phalange [fuh-lan-jee]; pl. noun: phalanges [fuh-lan-jeez].

From the Greek, phálanx, meaning military formation; later used for the bones of fingers and toes

Anatomy def: 14 bones in the digits of each hand or in the toes of each foot; 56 phalange bones in total. Each thumb and great toe bears two phalanges and remaining digits each contain three phalanges.

Outlander def: Smashed but healing finger bones of Jamie’s puir left hand (right hand in Diana’s books). Claire’s own loving hands diligently labor to mended them!

Learn about phalanges in Anatomy Lesson #22, “Jamie’s Hand – Symbol of Sacrifice.”

Read about Jamie’s smashed bones in Dragonfly in Amber:

Jamie glanced dispassionately at his right hand. It really wasn’t too bad; a couple of fingers set slightly askew, a thick scar down the length of the middle finger. The only major damage had been to the fourth finger, which stuck out stiffly, its second joint so badly crushed that the healing had fused two finger bones together. The hand had been broken in Wentworth Prison, less than four months ago, by Jack Randall.

See Murtagh Fitzgibbons Fraser tighten the laces of Jamie’s amazing hand brace, in Starz episode 202, Not in Scotland Anymore. Designed to stabilize his healing phalanges, Clever Cunning Claire likely devised this awesome medical appliance!

A deeply grateful,

Outlander Anatomist