Ballard Syndrome

Inherited brachydactyly syndrome not affecting other organ systems.

Brachydactyly, Combined types B and E; Pitt Williams Brachydactyly.

Twelve members in five generations of a family with autosomal dominant inheritance of this subtype of brachydactyly have been described. The syndrome is named after the affected family.

Members of this family have shortened metacarpals and metatarsals IV and V. Broadened thumbs were described in some members, as well as dysplastic fingernails (grooved and koilonychia-like) on the affected fingers and toes. In 1951, Julia Bell classified the brachydactylies in five main groups (A-E). This present form of brachydactyly combines the features of type B and E. Type B involves index to little fingers and is characterized by a symmetrical deformity with hypoplasia or absence of the distal phalanges with absence or dysplasia of the affected nails. Changes on the ulnar side are more pronounced than changes on the radial side. In type E, one or more metacarpals are shortened, either with or without shortening of the metatarsals.

No anesthetic implications arise from the described features.

Brachydactyly is a common feature of many syndromes. Its significance results from the association with other abnormalities. If brachydactyly is found, a thorough clinical examination is warranted, looking for other malformations that might have specific implications for anesthesia.