Congential Malformation of the Hand

Being relatively rare, congenital malformations of the hand usually come as an unexpected event for the parents of the child concerned. The manifestations and surgical correction options are so variable that operation concepts can only be created on an individual basis. The appropriate point in time also depends on the type and characteristics of the malformation. Every malformation of the hand should therefore be introduced to a plastic surgeon who is experienced in the remediation of such malformations in approximately the second month of life, so that the malformation and its extent can be diagnosed on a very fundamental basis, and the meaningfulness of and/or options available for corrective surgery can be discussed with the child's parents.

Constriction rings need to be operated as soon as possible to improve the blood circulation in the cut-off part of the extremity. Some malformations of the hand such as, for example, certain forms of syndactyly (when digits are fused together) are advantageously corrected at the age of six months, and most of them before the end of the first year of life. In specific cases, this helps to prevent impeded growth and hence a further deformation of the fingers, while the development of the hand's grasping function will thus generally be already attuned to the newly created situation.

Where the most common malformation of the hand is concerned, i.e. syndactyly (where fingers are more or less fused together), the fingers are separated under a general anaesthetic by way of highly sophisticated incisions, and skin grafts applied that are usually taken from the groin. If the graft is taken from an inconspicuous area in the groin, the operation will as a rule lead to highly satisfying results in aesthetic and functional terms.