A thirty five-year-old male had deformed hands and feet since birth. His growth, development and general health were unaffected except for his short stature (height-one hundred and thirty cms.) in comparison to other family members. There was no history of consanguinity, or mutagenic exposure in the mother during the antenatal period and there was no family history of similar deformity. Examination revealed bifid hands with two digits each and right and left foot with two and three toes respectively (Figure 1 and 2). Radiological examination of the hands revealed bilateral complete absence of second, third and fourth digital rays, presence of two carpal bones on the right side and only one carpal bone on the left side along with hypoplasia of radius and ulna and subluxation of inferior radio-ulnar and radio-carpal joints. X-ray feet showed absence of three lateral rays on right side and two lateral rays on left side, presence of calcaneum on the right side and calcaneum and talus on the left side, hypoplasia of phalanges and absence of both fibulae.
X-rays of chest, spine and skull were normal. Examination of teeth, hair, nails, mucosae and eye did not reveal any abnormality. A skin biopsy showed normal sweat glands.
