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Figure 4.29. The appearance of this hand is very typical of infants with trisomy 18, occurring in about 50% of affected infants. Note the clenched hand with a tendency for die index finger to overlap the third and for the fifth finger to overlap die fourth. At times these fingers are extended, giving die appearance of the sign for "I love you" in American sign language. Infants widi trisomy 18 also commonly have hypoplasia of die nails on both the fingers (especially die fifth finger) and the toes.

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