Congenital hand deformities 

Learning that your child has a congenital hand deformity can feel overwhelming. Congenital hand deformities occur when your child’s hand and fingers don’t develop as expected during pregnancy. These deformities can affect how your child’s hand functions and grows, but there are various treatment options to help.

Our team of child orthopedic surgeons are here to provide support, guidance and expert care every step of the way. Whether your child needs surgery, therapy or ongoing medical management, we are dedicated to helping your child thrive.

What are congenital hand deformities?

Congenital hand deformities, also known as hand birth defects, happen when your child is born with a hand that never properly developed. These deformities come in several shapes and sizes and can range from mild to severe and may affect one or both hands.

Congenital hand deformities occur due to issues with the formation of the hand or arm while the baby is still developing in the womb. Some children may have an extra finger (polydactyly), while others may experience undergrowth or overgrowth of certain parts of the hand or fingers (hypoplasia).

Hypoplasia

Hypoplasia is the underdevelopment or incomplete formation of the thumb, which can be smaller than normal or, in some cases, missing entirely. This can affect the function and strength of the hand, making it difficult for a child to grasp or manipulate objects.

If your child’s thumb is missing completely, surgery will be needed. In some cases, another finger, typically the index finger, is moved so it can function as a thumb.

Clinodactyly

Clinodactyly occurs when the bones in the finger grow abnormally, specifically the middle finger. Clinodactyly can be mild, with only a slight curve, or more noticeable, potentially affecting hand function. It’s often visible at birth but can become more noticeable as a child grows. In many cases, clinodactyly doesn’t cause significant problems and may not require treatment. However, if it interferes with hand function, surgery may be considered to straighten the finger.

Ectrodactyly

Ectrodactyly, also known as "split hand" or "club hand," is a rare condition where the central fingers of the hand are missing or underdeveloped, resulting in a cleft or V-shaped appearance.

Ectrodactyly can affect one or both hands and sometimes occurs alongside similar deformities in the feet. Some children may have normal function in their hand, while other children may experience significant limitations.

Treatment for ectrodactyly often includes surgical procedures to improve the hand's appearance and function, as well as occupational therapy to help the child adapt to daily tasks.

Camptodactyl

Camptodactyly is a congenital condition where one or more of the fingers are permanently bent, typically at the middle joint. This deformity most often affects the pinky finger and can occur in one or both hands.

Camptodactyly can be visible at birth or develop during childhood or in the teen years. It’s usually painless, but in more severe cases, the curve can limit hand function.

Treatment depends on the severity of the deformity and may include physical therapy, the use of splints or surgery to improve finger flexibility and function. However, mild cases may not require any treatment.

What is the most common congenital hand deformity?

Polydactyly is the most common congenital hand deformity. In many cases, children with polydactyly are born with an extra finger that may appear on the thumb side (radial), the little finger side (ulnar) or in the middle of the hand (central).

What causes congenital hand deformities?

Congenital hand deformities usually develop during pregnancy due to abnormal formation of the hand and arm. While the exact cause of these deformities isn't always clear, genetic factors can play a significant role.

In some cases, congenital hand deformities may occur in families with a history of them, such as polydactyly or ectrodactyly. Other potential causes include issues related to the baby's development in the womb, where parts of the hand do not form or separate properly, or reduced blood flow.

What diseases cause hand deformities?

Certain diseases and genetic disorders can increase the risk of congenital hand deformities. Conditions like syndromic polydactyly (polydactyly associated with other genetic syndromes), ectrodactyly and radial club hand are often linked to genetic mutations.

Other conditions that can contribute to congenital hand deformities include:

• Amniotic band syndrome: This occurs when strands of the amniotic sac wrap around parts of the fetus, potentially restricting the growth of the limbs and causing hand birth defects.
• Holt-Oram syndrome: A genetic disorder that affects the development of the bones in the arms and hands, often resulting in abnormalities such as a deformed hand or hypoplasia of the thumb.
• Apert syndrome: A genetic condition that causes premature fusion of bones in the skull and syndactyly (webbing of fingers), leading to a congenital hand anomaly.

Diagnosing congenital hand deformities

Congenital hand deformities are often diagnosed shortly after birth or during a routine prenatal ultrasound. In some cases, the deformity may be identified early in pregnancy, allowing you to discuss potential treatment options before your baby is born.

After birth, your child's pediatrician may conduct further tests, such as X-rays or genetic screenings, to assess the severity of the hand anomaly and determine the best course of treatment.

What are treatments available for congenital hand deformities?

The treatment of congenital hand deformities depends on the type and severity of the condition. At Advocate Children’s Hospital, our hand surgeons and specialists work closely with families to develop a personalized treatment plan that supports your child's needs. Common treatment options include:

• Surgery: Surgical intervention is often necessary to correct severe hand deformities, such as polydactyly or hypoplasia. Surgery may involve removing extra fingers, reconstructing underdeveloped thumbs or correcting radial deviations. In some cases, multiple surgeries may be needed over time as your child grows.
• Therapy: Rehabilitation therapies may be recommended after surgery or as a standalone treatment to help improve your child's hand strength, flexibility and function. Our therapists will work with your child to develop fine motor skills and adapt to their unique hand structure.
• Prosthetics: If your child has a more severe hand deformity, such as the absence of fingers or parts of the hand, prosthetics can offer functional and cosmetic benefits. Custom prosthetics are designed to fit your child's needs and can help them participate in everyday activities with greater ease.
• Nonsurgical management: In mild cases, where the deformity doesn’t significantly affect hand function, nonsurgical options such as the use of splints or observation may be recommended.