Congenital hand abnormalities form in the early stages of an infant’s development in the womb, and the degree of impairment ranges from disproportionate fingers to severe deformities such as an absence of bone.
Hand abnormalities are particularly disabling for your child, as their early interaction with the environment is usually via their hands. The most common type of hand abnormality is where the soft tissues or bones of the fingers fail to separate during development and remain fused together. Sometimes an extra digit forms during development, most commonly an extra little finger. Undergrowth of a digit is where a thumb or finger is small compared to the other digits, muscles are small or missing or bones are underdeveloped or missing. Occasionally there is a complete absence of a digit. Overgrowth of a digit refers to an abnormally large digit, which may involve the hand and forearm as well. It usually affects the index finger.
Constriction, or amniotic band syndrome is the growth of a constricting tissue band around a finger or arm, which can impede blood flow and normal growth of the affected part. The condition may affect more than one digit and can be associated with other congenital abnormalities like Cleft Lip, Cleft Palate and Clubfoot.
Severe abnormalities include Radial Cubhand and Ulnar Clubhand. Radial Clubhand involves all the tissues on the thumb side of the forearm and hand where there may be bone shortening, a small thumb, or no thumb, and underdeveloped muscles. The less common Ulnar Clubhand is an underdevelopment of bones and muscles on the little finger side of the arm and hand. In both these cases, surgery is not indicated and your child may benefit from wearing a prosthetic device to increase function.
Surgical treatment of congenital hand abnormalities varies in complexity depending on the condition, and Mr Kode will advise you of the most appropriate procedure. Surgery for fused digits usually involves making zig-zag incisions to separate the digits, as this generally result in less scarring. Skin grafts may be needed to cover tissue gaps between the separated digits and these are most often taken from your child’s groin area, allowing for easier concealment of the scar in the natural skin crease there. An extra digit is generally removed, with the remaining digit’s bones, ligaments and tendons reconstructed. Digits affected by constriction band syndrome are usually operated on in stages, with gradual release and removal of each digit’s tissue bands, as well as re-contouring the digits if they have a puffy appearance due to the constriction.
Mr Kode regularly performs Paediatric Plastic Surgery. For more information please contact our practice.