Congenital hand deformities are the structural anomaly of the hands present with the birth of the infant. The severity of the condition can vary from webbed fingers, underdevelopment of the hand to the entire absence of a bone. The upper limbs of the fetus develop during the fourth and the eighth week of pregnancy. There are several causes that result in the limb deformities, while some are attributed to the genetic condition, the others still remain unknown.
Deformity of the hands can be particularly challenging for a child learning to associate with the social environment using their affected hands. Early consultation with a surgeon may be necessary for a reconstructive surgery, otherwise, prosthetic devices and physical therapy may be useful in improving the individual’s lifestyle. The reconstruction surgery may be performed within the first 2 years of the child’s life in order to promote full growth and development. The early surgical intervention also results in less psychological effects for the child.
Polydactyly
This is a common condition affecting approximately 1 in 1,000 babies born with an extra finger or a toe that may be complete or incomplete. Occasionally, the infants may also have several extra digits. The additional finger normally consists of a small piece of soft tissue which may contain bone and is rarely fully functioning. There are several types of polydactyly depending on the location of the digit. Radial polydactyly is the presence of the extra digit on the thumb side, ulnar polydactyly is the presence of additional digit outside the little finger and central polydactyly is its presence in the center between the other fingers.
Clubhand
The radial club hand is the result of the underdevelopment of the radius bone in the arm or its entire absence resulting in the hand that turns inwards. The forearm may be short with a small or no thumb at all. Generally, the child with this deformity of the wrist can be operated around 6 months of age.
The ulnar clubhand is not as common as the radial clubhand and may result in the shortness or in the absence of the ulnar bone. The bone of the forearm on the side of the little finger is known as the ulnar bone. The children with this clubhand may be introduced to prosthetic devices early in their life.
Syndactyly
This deformity occurs when the fingers fail to separate in the womb resulting in their webbed appearance at birth. Syndactyly is the most common type of congenital hand deformity usually involving the fusion of middle and ring fingers. The fusion of the entire length of the fingers is known as complete syndactyly, the partial fusion of fingers in their length is the incomplete syndactyly and fusion involving other adjacent finger bones are termed as complex syndactyly.
Symbrachydactyly
Infants born with this condition have a short or missing finger. This may develop in one hand while the other may be normal. Some of the digits may be stiff, smaller than normal and may have fusions of the digits. In some cases, the infant may have missing bones of the digits and short forearm. These individuals may also have their muscles, tendons and ligaments affected.
Treatment
Treatment may be based on the overall health condition of the child, age and the cause of the condition. The types of treatment for congenital hand deformities may include the tendon transfer, correction of contractures, limb manipulation, splinting of the affected limbs and skin grating. In other cases, prosthetics may be used when surgery is not possible due to the child’s poor health. A physical therapy may be necessary to strengthen and help with the functions of the affected hand.