The hand and foot malformation is severe, described as split-hand/split foot deformity. It may involve all four extremities or just the upper extremity with monodactyly. When the hand is involved, it may be called a lobster-claw deformity, or ectrodactyly. The middle digit is characteristicly missing but other fingers and toes are sometimes absent.
The teeth erupt late, some may be missing and others are often poorly formed. Frontal bossing, sunken cheeks, and thick and everted lips may be part of the facial phenotype.