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

 

 

Cape Fear River Basin and Alamance Battleground!

Hello, Outlander fans!

Season 5 blasts off in one month. I can scarcely wait! You? 🤗

Today, I post about my recent trip to  North Carolina, the US state that is integral to the Outlander saga beginning with Season 4 and beyond.

Now, please dinna run away. This is truly interesting stuff!

I visited several sites that appear in the fifth big book, The Fiery Cross (TFC), the source for Outlander, Season 5.

You will remember at the end of Voyager book and S3, Jamie and Claire survived a hurricane to land in the Colony of Georgia.

Mrs. Olivier smiled indulgently. “You are not on an island at all. You are on the mainland; in the Colony of Georgia.”

“Georgia,” Jamie said. “America?” He sounded slightly stunned, and no wonder. We had been blown at least six hundred miles by the storm.

“America,” I said softly. “The New World.”

At the beginning of  Drums of Autumn book, Jamie.com find themselves in Charleston, SC, and then they travel north to Wilmington. But, season four left out that bit of travelogue and opens in Wilmington, NC.

This quote from Drums of Autumn explains:

Out of the sun, with a large pewter mug of dark ale foaming gently in front of him, Jamie quickly regained his normal self-possession.

“We’ve the two choices,” he said, brushing back the sweat-soaked hair from his temples. “We can stay in Charleston long enough to maybe find a buyer for one of the stones, and perhaps book passage for Ian to Scotland on another ship. Or we can make our way north to Cape Fear, and maybe find a ship for him out of Wilmington or New Bern.”

I really wanted to see Wilmington for myself. So, hounding my son to drive me three hours to Wilmington was a must!

Yes, Wilmington, where Hayes met his sad fate at the end of a hangman’s noose!

Yes, Wilmington, where Brianna was handfast to Roger, on the most magical night of her young life.

Yes, Wilmington, where Brianna paid a horrific price for her mother’s iconic wedding ring, forged from the key to Lallybroch.

Why is Wilmington important beyond the Outlander story? When the Carolina region was divided in 1712, the line between North and South Carolina was established to ensure North Carolina received its own seaport, Wilmington.

Today, Wilmington is a lovely old city, a blend of modern and old including many beautiful homes boasting historic markers.

Wilmington straddles the Cape Fear River, which I filmed from the aft deck of the battleship USS North Carolina, as it (not the battleship 😉) flows toward the Atlantic Ocean. The battleship is permanently moored on this river!

I strolled along the Wilmington Riverwalk, a shop- and eatery-lined pathway following the river.

At Wilmington, the 200-mile-long Cape Fear River is large enough to accommodate sea-faring vessels, cargo crates and tugboats, as is befitting a true seaport. 

The Cape Fear River collects water from streams and rivers of the Cape Fear Water Basin, a 9,000+ sq. mi. area stretching beyond Greensboro, the city I just left!

Water from this massive land area drains into the Cape Fear River, ultimately flowing past Wilmington and into the Atlantic a few miles downstream.

Do you see Fayetteville, NC, on the map below? It sits on the Cape Fear River but further inland than Wilmington.

Fun Fact: Did you know Fayetteville started life in 1756 as Cross Creek, the settlement nearest to Aunt Jocasta’s River Run plantation. Truth! 

During the American Revolution, Cross Creek was a hotbed of wartime activity and home of divided loyalties, many of those conflicts involved Highland Scots! Its name was changed to Fayetteville in 1783.

Lastly,  Cape Fear, might sound familiar to you because Martin Scorsese’s 1991 film of the same name was situated in this region. Cape Fear is a prominent headland jutting into the Atlantic Ocean at the mouth of the Cape Fear River.

Aunt Jocasta’s splendid River Run plantation near Cross Creek (Fayetteville), most likely sat in the Cape Fear River Basin.

Moving on.

A couple of days later, my dear son drove me to the Alamance Battlefield. The Battle of Alamance was the final conflict in the War of Regulation, a rebellion in North Carolina over issues of taxation and control. Some historians and locals consider the Battle to be the opening salvo of the Revolutionary War!

The battleground is a beautiful, serene wooded site bordered by zigzagged split rail fencing and a few miles outside Greensboro .

The woods are quiet now but on May 16,  1771, the countryside rang with shots and shouts from Regulators and Tryon’s militia.

The  image below shows where the Regulators held ground on the rise in the background. Tryon’s forces would have been about six miles in the opposite direction across Great Alamance Creek.

As faithfully recorded in TFC, Herman (Harmon/Hermon) Husband was a leader in the rebellion who left the battlefield early.

I wondered what brought Hermon Husband here—and whether he was being followed. He owned a farm and a small mill, both at least two days’ ride from the Ridge; not a journey he would undertake simply for the pleasure of our company. 

Husband was one of the leaders of the Regulation, and had been jailed more than once for the rabble-rousing pamphlets he printed and distributed. The most recent news I had heard of him was that he had been read out of the local Quaker meeting, the Friends taking a dim view of his activities, which they regarded as incitement to violence. I rather thought they had a point, judging from the pamphlets I’d read.

Now one bit of history…. militia men did not wear uniforms; these were ordinary citizens on both sides of the conflict. We have all seen and speculated about Jamie Fraser appear in a redcoat in Outlander Season 5 footage.  So why is he wearing that redcoat? Time will tell, but I wager it has to do with advancing the story at the expense of historical accuracy. 😉

Psst… whatever the reason, he looks mighty fine!

Spoiler! The battle was fairly brief and the loss of life modest given that Tryon had 1,000 militiamen and the Regulators, 2000.  Tryon captured 13 Regulators: one was executed at camp and six were executed later in nearby Hillsborough. Hanging was the method of the day.

This bit of history is pertinent to Season 5, so ‘nuf said! 😉 😉

What a trip!

Thank y ou for joining me on my whirlwind tour of book 5 (excepting Fraser’s Ridge, an area I explored in 2015).  This trip, I visited Wilmington, where Bree was handfast to Roger and assaulted by the dread pirate, Steven Bonnet! I walked the Cape Fear River into which most rivers and streams of the Cape Fear Water Shed drain and home to Cross Creek and River Run. And, I visited the Alamance Battlefield, the site where Regulators clashed with Governor Tryon’s militia.

As always, I am deeply grateful. Yay!

The deeply grateful,

Outlander Anatomist

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Photo and Video Credits: Sony/Starz, Wikipedia, Outlander Anatomy, Wilmington-nc.com, nchistory.WordPress.com