Four-finger furrow

The Four-fingered fox is a palm line that is common on people with some form of trisomy. The presence of a four-finger furrow has no pathological value in and of itself, since the hand line does not impair the function of the hand. For this reason, four-finger furrows do not have to be specifically treated in healthy people or in trisiomy patients.

What is a four-finger fox?

The Palm has different hand lines, also known as Hand furrows are designated. In alternative medicine, the belief is widespread that diseases and dispositions can be read from the grooves in the hands. In fact, there is a type of science-based palmistry.

Under certain circumstances, the hand lines really reveal something about possible diseases, such as rare hand furrows like the Four-finger furrow. The Transverse palmar creaseas it is also called, is a crease located on the palm of the hand with a perpendicular course to the longitudinal axes of the fingers and parallel to the metacarpophalangeal joints.

The furrow extends from the index finger to the little finger and can be symptomatic of various diseases. However, the four-finger furrow is not always to be understood as an indication of a disease. In the normal population, the furrow occurs in at least one in 100 people. The term four-finger furrow has replaced the monkey furrow or barrier line. Monkey furrow refers to the context that higher order primates often wear such a furrow.

causes

All humans have furrows in the palms of their hands. In most cases it is a question of rounded furrows that run in an individually curved arc. The four-finger furrow is not widespread in the normal population and is more an anomaly than a norm. Different trisomies, for example, are possible causes for the line.

While the four-finger furrow only occurs in one out of a hundred healthy people, it is present in 75 percent of all people with trisomies. Trisomies are triples of chromosomes or chromosome segments, such as, for example, Down syndrome, Patau syndrome, Edwards syndrome, trisomy 16, trisomy 8 as well as Zellweger syndrome, Aarskog-Scott syndrome, C-trigonocephaly Syndrome, Noonan syndrome, and Smith-Magenis syndrome.

Patients with Wolf-Hirschhorn syndrome, Smith-Lemli-Opitz syndrome, De-Grouchy syndrome, Schinzel-Giedion syndrome and cat-cry syndrome also wear the furrow more often than people without chromosomal features. As a result, a chromosomal abnormality may be the cause of the phenomenon. However, there is no necessarily pathological connection.

Symptoms, ailments & signs

In principle, the four-finger furrow is not an impairment. The mobility and function of the affected hand are fully preserved. The only clinical relevance of the furrow is its possible context of chromosomal diseases. If the four-finger furrow actually occurs as part of a chromosomal aberration, there is usually a single furrow on the fifth finger in addition to the furrow.

Both furrows together suggest a pathological peculiarity. The four-finger furrow alone has no pathological value in itself. Even if a four-finger furrow and a single hand furrow are present on the fifth finger, a pathological basis is not automatically confirmed.

Only if the patient has manifest clinical symptoms can one speculate about a trisomy due to the peculiarities of the palms. The symptoms of a trisomy depend on the length and type of the tripled chromosome segment. In most cases, chromosomal abnormalities of this type result in various malformations of tissues or organs, which can differ significantly in severity.

Diagnosis & course of disease

The presence of a four-finger furrow does not necessarily have to be of diagnostic value. Since the furrow can also occur in very healthy people, a four-finger furrow alone must not be considered a chromosome anomaly. Trisomies are usually diagnosed on the basis of characteristic symptoms, organ-specific diagnostics and molecular genetic analysis.

Abnormal hand drawings such as the four-finger furrow can be recognized by visual diagnosis and can be included in the case description if a trisomy has already been diagnosed. The prognosis for patients with a trisomy depends on the type and length of the tripled chromosome segment. If the four-finger furrow is independent of trisomies, it does not affect the function of the hand or the health of the patient.

Complications

A four-finger furrow does not always have to result in complications or discomfort. The disease can also occur completely without discomfort or restrictions, so that those affected can move their hand without further ado. However, the repeated occurrence of a four-finger furrow can lead to complaints when moving and thus to restrictions in everyday life.

In many cases, those affected also suffer from malformations of the internal organs, so that various examinations are necessary. However, these malformations can be very different so that a general prediction is not possible. The four-finger furrow can also lead to aesthetic complaints, so that those affected feel uncomfortable with the complaints or are ashamed of them.

In children, the condition may also lead to bullying or teasing, and thus depression and other psychological complaints. The four-finger furrow generally reduces the person's quality of life. The treatment is also based on the exact complaints and can limit them.

There are no particular complications. Most of the time, the symptoms can be alleviated. With this disease, the life expectancy of the person affected is only restricted when severe malformations of the internal organs have occurred.

When should you go to the doctor?

The four-finger furrow is an optical change in the palm of a person. This can be seen immediately after birth through visual contact.Basically, the hand line does not represent a disease value. It is by no means an independent disease. Rather, the four-finger furrow is a symptom of an existing health disorder and can indicate a trisomy. The perception of the visual abnormality should therefore be discussed with a doctor immediately. The person concerned cannot react naturally, so parents should immediately consult a doctor as soon as they notice the peculiarity of the hand line.

In most cases, the birth takes place in an inpatient setting or in the presence of a midwife. Since an extensive health examination of the newborn takes place immediately after the birth, the four-finger furrow is noticed by the medically trained staff under optimal conditions. Further steps are decided in consultation with the parents and medical tests are carried out.

There is therefore only a need for action in a large number of cases if the visual change in the palm of the hand should go unnoticed during the first examinations after the birth. If there are abnormalities or peculiarities of behavior or appearance in the further growth process of the child, consultation with a doctor should be sought.

Treatment & Therapy

A four-finger furrow alone is not an indication for therapy. Even in the context of trisomies, the four-finger furrow is not treated any further, since the abnormal hand drawing does not impair motor skills. In the larger context of trisomies, however, numerous other symptoms arise that absolutely require therapy.

Treatment in this case depends on the type of trisomy and the symptoms present. To date, causal treatments are not available for patients with trisomies. Since the cause of the disease lies in a multiplication of the genetic material, advances in gene therapy in the course of the next few decades can at most open up causal treatment options.

So far, the treatment of trisomy patients has been purely symptomatic. The focus is initially on the correction of organic dysplasias, which is a vital therapeutic step in the context of various trisomies from a certain degree of severity. In addition to invasive measures, conservative medicinal and, above all, supportive therapy steps are available for the symptomatic treatment of some trisomy symptoms. Merely a cure cannot be achieved due to the lack of causal therapy.

prevention

A four-finger furrow cannot be prevented. In principle, prevention is also not necessary, since the anomaly as a singular phenomenon has no disease value. To prevent trisomies, genetic counseling in the family planning phase can be useful.

Aftercare

In general, the four-finger furrow does not need treatment. Follow-up care is therefore not necessary. Surgical intervention may be an option for patients with hereditary diseases such as Zellweger syndrome or Aarskog syndrome. This depends on the form of the four-finger furrow and any other malformations.

The four-finger furrow itself is not a priority in treatment and aftercare. The most important follow-up measure is to monitor the other symptoms of the underlying disease and to provide the patient or the parents with further measures to be able to deal better with the clinical picture. The general practitioner takes care of the follow-up care for a four-finger furrow.

He determines the four-finger furrow and can refer the patient to a suitable specialist. Hereditary diseases can usually be recognized by other, more pronounced symptoms. The four-finger furrow is a typical sign that must be included in the diagnosis. After the causal disease has been diagnosed, further therapeutic measures can be discussed.

Due to the large number of possible diseases that can be associated with a four-finger furrow, follow-up care must always be selected individually. Follow-up care is determined by the responsible doctor. If the four-finger furrow occurs without a causal disease, no follow-up care is required.

You can do that yourself

A four-finger furrow is not a physical nuisance. Treatment of the external feature is not necessary as long as the furrow is not unusually pronounced and thereby restricts the mobility of the hand.

Parents who notice a four-finger furrow in their child are best to speak to the pediatrician. Further examinations can determine whether the four-finger furrow is due to a genetic change such as trisomy 21. Usually, however, the external signs are sufficient to determine or rule out such a disease yourself. If the four-finger furrow occurs regardless of disease, no further measures need to be taken. The child can later be educated about the cause of the four-finger furrow. If the four-finger furrow occurs as part of a disease, it must first be treated.

The monkey furrow itself does not require any treatment. It occurs in up to four percent of the European population and has no further relevance to the health of the child. Nevertheless, any abnormalities should be observed and, if necessary, a specialist should be consulted. Research is ongoing, particularly in the area of ​​genetic diseases, and new findings that establish a connection between the four-finger furrow and physical diseases cannot be ruled out.