Figure 4.53. This infant with trisomy 21 has a single palmar crease. There is no clinodactyly but there is hypoplasia of the middle phalanx of the fifth finger as noted by the decreased distance between the finger creases. The single palmar crease is seen in about 45% of infants with trisomy 21 and is a finding in many other syndromes.
Figure 4.54. This infant with trisomy 21 has clinodactyly but normal palmar creases. Clinodactyly with an absent or hypoplastic middle phalanx of the fifth finger is present in about 50% of infants with trisomy 21.
Figure 4.55. The gap between the first and second toes ("sandal" or "thong" sign) is a typical finding in trisomy 21. The feet are broad and short. The plantar surfaces are creased with a deep long furrow (ape-line) between the first and second toes.
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