What is Congenital Hand Deformity?

Congenital hand deformities encompass all abnormalities present at birth. Any type of deformity in a newborn can progress as the child grows and make life difficult. Hand deformities can be particularly debilitating when children begin to interact with their environment using their hands. The degree of the deformity can range from a minor deformity, such as unequal fingers, to a more serious deformity, such as the complete absence of a bone.

Approximately 1-2% of babies are born with congenital hand deformities. About 10% of these deformities are seen in the hands. The most common congenital hand deformities are syndactyly (fused fingers) and polydactyly (extra fingers).

Early consultation with a hand surgeon is a crucial part of the treatment process for a child born with hand deformities. Many types and forms of interventions, both surgical and non-surgical, can be performed functionally and cosmetically.

Fused Fingers

In this type of deformity, the parts of the hand, bones, or tissues do not separate in the womb. The most common type of this classification is syndactyly (fused fingers). Syndactyly is the fusion of two or more fingers. There is a familial predisposition. There are two types of syndactyly:

Simple Syndactyly: Only the tissues are fused.

Complex Syndactyly: There is fusion between the bones. It is usually seen in specific diseases such as Apert Syndrome.

Extra Fingers

Duplication of fingers is also known as polydactyly. The little finger is the most frequently affected finger. It can be seen on the thumb side, the little finger side, or in the middle of the hand. A treatment plan specific to the patient is made according to the developmental characteristics of the extra finger.

Short Fingers (Simbrachydactyly)

Underdeveloped fingers or thumbs are associated with many congenital hand deformities. Surgical treatment may not always be necessary to correct these deformities. Underdeveloped fingers may be smaller than normal, have muscle development problems, have little or no bone development, or the finger may be completely absent.

Big Finger

Overdevelopment of fingers, also known as macrodactyly, results in an abnormally large finger. In this case, the hand and forearm may also be affected. In this rare case, all parts of the finger (or thumb) are affected; however, in most cases, only one finger is affected (usually the index finger). Early diagnosis and treatment of macrodactyly are very important. While early treatment can yield positive results, late diagnosis can result in finger loss.

Treatment of Congenital Hand Deformities

The treatment of congenital hand deformities is determined individually for each child. The child’s age, the degree of limb involvement, the cause of the condition, the child’s response to the planned treatment, and the family’s expectations, opinions, and preferences are important factors in determining the treatment choice.

Treatment options include manipulation and stretching, custom splinting, tendon transfers, external device use, physical therapy (to increase hand strength and function), contracture release, reconstruction or removal of the extra limb, reconstruction of the missing limb, and prosthetic applications.

During treatment planning, the primary goal is to concretely increase functional capacity, followed by improvement of the cosmetic outcome.