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Despite being one of the rarest congenital upper limb abnormalities, a wide spectrum of the typical mirror hand has been described in the literature. We report a very interesting case of a new variant of mirror hand presenting in a 78-year-old man. The unique features of the case include  the age at diagnosis, the anatomical features present and the acquired function despite no form of reconstructive surgery.

The oldest reported mirror hand? The curse of the coal-house frog!