Congenital Hand Differences

Congenital differences in the hand are a common reason for referral to hand surgeons and pediatric plastic surgeons. Congenital hand differences are more common than cleft lip and palate and are second only to congenital cardiac anomalies in their frequency. In this chapter, we will review the five most common conditions leading to referral to a pediatric hand surgeon. The most common condition, though arguably not truly a congenital anomaly, is trigger thumb. The other conditions discussed, in order of their frequency, are preaxial and postaxial polydactyly, syndactyly, and thumb hypoplasia. For each of these conditions, we will describe the evaluation and treatment of the disorder and then enumerate various technical points that facilitate diagnosis and treatment.