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Private surgery for congenital hand problems

We use our hands more than we think and hand problems in children can affect their development quite severely. Your child may need hand surgery to correct a congenital hand problem – one they were born with, or to treat a condition that has developed since birth. Hand surgery can also help fix damage caused by accidents and trauma to their hand. The surgical treatment of congenital hand problems involves planned hand surgery carried out by a specialist hand or orthopaedic surgeon, or sometimes by a plastic or reconstructive surgeon, depending on the nature of the problem. This usually takes place at a children’s hospital or specialist unit and hand surgery is available at several private paediatric units in the UK.


The ultimate goal of hand surgery is to restore and maintain the function and appearance of your child’s hand.


Congenital hand problems that may need hand surgery

There are multiple types of congenital hand abnormalities, which generally fall into one of the following classifications:

  • Failure of formation

  • Failure of differentiation

  • Duplication

  • Overgrowth

  • Undergrowth

  • Constriction ring syndrome (fibrous bands of the amniotic sac that contains the foetus within the womb become tangled around the limbs or digits causing them to swell)

  • Generalised abnormalities


Congenital hand problems can include lack of fingers or thumb, extra digits, over- or under-development of digits, clefts, conjoined digits, or curved digits. Not all abnormalities require hand surgery. Some – for example, figures that are too curved can be treated using splints alone, or with a combination of splints and later hand surgery. In other cases, there are strong cosmetic and functional reasons to have specialist paediatric hand surgery done as early as possible.


Hand surgery can usually be done soon after the age of 6 months, when your child is large enough to have a general anaesthetic. Removing the problem at this age will allow your child to develop normal hand function as they grow. Early hand surgery will also help to prevent the development of permanent deformity that could make them the focus of teasing and bullying at school.


Some congenital hand abnormalities that are typically treated with hand surgery include:

  • Syndactyly – where the web spaces between digits have not divided and the digits need to be separated. The condition is described as simple if there is fusion of soft tissues only, or complex if the bones are also fused

  • Polydactyly – duplication of any of the digits, most commonly the thumb

  • Hypoplastic thumb – an under-developed thumb that can’t be used normally

  • Ganglion – a harmless cyst-like swelling next to a joint or tendon in the wrist

  • Radial or ulnar club hand  - both are rare conditions that result from underdevelopment of either the thumb side of the hand or the little finger side

  • Congenital trigger thumb and finger – this is caused by thickening of the tendons or muscles just below the digits


Hand surgery can involve several different types of procedures, such as separation of soft tissue, separation of fused bones, tendon transfer, stretching or manipulation of the hand and its internal structures. Surgeons may also perform skin grafts, digit reconstruction/toe-to-hand transfer, and make use of prosthetics to rebuild your child’s hand.