Early consultation with a Plastic surgeon is an important part of the treatment process for the child born with a hand deformity.
The classifications for hand deformities can vary. The classifications listed below have been accepted by the American Society for Surgery of the Hand. Classifications may change as more knowledge is obtained regarding each of the conditions. There are seven groups of deformities of the hand that will be discussed, including the following:
This occurs when parts of the body stop developing while the baby is in the womb, causing either a complete absence of a part of the body, such as the hand, or a missing structure, such as part of the arm bone. In the case of the complete missing part, surgery is not indicated. These children may be introduced to prosthetic devices early in their childhood.
Types of this classification include, but are not limited to:
With this type of deformity, the parts of the hand, either the bones and/or the tissues, fail to separate in the womb. The most common type of this classification is syndactyly. Syndactyly is the most common congenital hand deformity, in which two or more fingers are fused together. There is a familial tendency to develop this deformity. If the fingers are completely fused together, it is considered complete.
There are two types of syndactyly, including the following:
Another example of failure of the hand to separate is seen in contractures of the hand. Contractures of the hand may also develop as a result of failure of the cells to differentiate in utero. A contracture is an abnormal pulling forward of the digits of the hand, usually caused by problems with the muscles or skin. One of the common types of this classification includes congenital triggering. Congenital triggering occurs when one of the digits is unable to extend. It is usually seen in the thumb. It may take some time in the child’s development before it is noted that the child can not extend the thumb. Some of these cases improve on their own. Surgery is usually not performed until the second year of life, but preferably before the age of 3.
Duplication of digits is also known as polydactyly. The little finger is the finger that is most often affected.
Underdeveloped fingers or thumbs are associated with many congenital hand deformities. Surgical treatment is not always required to correct these deformities. Underdeveloped fingers may include the following:
Overgrowth of digits is also known as macrodactyly, which causes an abnormally large digit. In this situation, the hand and the forearm may also be involved. In this rare condition, all parts of the finger (or thumb) are affected; however, in most cases, only one digit is involved (usually the index finger). Surgical treatment of this condition is complex and the outcomes may be less than desirable. Sometimes, amputation of the enlarged digit is recommended.
This occurs when a tissue band forms around a digit (finger) or limb (arm), causing problems that can affect blood flow and normal growth. Ring constrictions are congenital (present at birth). This condition may be associated with other problems, such as clubfoot, cleft lip, cleft palate, or other craniofacial anomalies. The cause of the ring constrictions is unknown. Some theories suggest that amniotic banding may lead to ring constrictions around a finger or limb.
With this condition, there are four degrees of severity, including the following:
Constrictions that cause deformities beyond the constriction
Constrictions that are associated with the fusion of parts of the finger
Constrictions so severe that part of the finger will need to be amputated from the process