Symphalangism in Hawaii: a study of three distinct ethnic pedigrees.

Symphalangism was introduced into Hawaii by a Cherokee Indian in the late 1800s. The resultant pedigree, along with two other racially distinct pedigrees, confirms that the condition is an autosomal dominant genetic trait. Associated conditions include carpal and tarsal coalitions, cervical fusions, brachydactylism, symphalangism of the toes, and hearing loss. Surgical intervention in the hands is seldom, if ever, indicated but correction of the associated hearing loss is rewarding.