Having hand differences can be both emotionally and physically challenging. While many children can adapt to it and function well without any treatment, some children might need occupational therapy, surgery, or other treatments to function better and be more independent. Book an appointment with Dr. Nilesh Satbhai today.
The term congenital hand difference means any condition of the hand and arm present at birth. Children can be born with different types of hand differences, and they vary in how they impact the function and appearance of the hand. Congenital hand differences develop early in the womb during pregnancy when the baby’s upper limbs are forming. Sometimes, it is hereditary (i.e. a difference runs in the family) or is part of a medical condition. Hand differences are usually not detected before birth. Occasionally, a difference, for example, extra fingers, thumb, or missing bones, can be seen on a prenatal ultrasound, but this is very rare. In most cases, the exact cause of a hand difference is not known.
Congenital hand differences are mainly divided into 4 categories:
Malformations: While the baby is in the womb, a certain part of the hand or arm fails to develop normally.
Deformations: These occur when the arm and hand begin to develop normally but they are prevented from doing so in some way.
Dysplasia: Dysplasias means an overgrowth of a part of the hand/arm or all of the hand/extremity. Dysplasias and deformations can occur at a later stage in pregnancy.
Syndromes: Syndromes are conditions where the hand difference is a part of other larger spectrum diseases.
Congenital hand differences treatment is the treatment and management of conditions where the hands do not develop normally. It is a multidisciplinary field that includes surgery, occupational therapy, and rehabilitation.
The goal of treatment is to improve function and appearance and to allow the child to be as independent as possible. Treatment options vary depending on the type and severity of the hand difference.
In some cases, no treatment is necessary, and the child will be able to adapt and function well without any intervention. In other cases, when the hand difference is more severe and affects the quality of life, treatment might be necessary to improve function and appearance.Book Appointment
During the consultation for congenital hand differences, you should expect to assist your child with undergoing a physical examination. You should also provide a complete medical history, including previous surgical procedures, past, and present medical conditions, and any current medications or herbal supplements. Discuss possible options with Dr. Nilesh Satbhai for treatment of the condition, including whether surgery is required or not. If surgery is recommended, Dr. Nilesh will discuss the surgical procedure with you in detail, including all the possible risks and complications of the procedure, the recovery and rehabilitation period, and the probable outcome in terms of function, appearance and support. Dr. Nilesh Satbhai may also request for additional diagnostic imaging tests to be done which include:
X-ray: To evaluate bones for deformity
CT scan: For more detailed imaging
Dr. Nilesh Satbhai will design a customized treatment plan based on the severity of the condition and the patient’s functional goals.
The main purpose of congenital hand differences treatment is to improve the appearance and function of the affected hand as much as possible and to support the child’s self-esteem. While some children can adapt to hand differences and function normally without treatment, others may need therapy or surgery to be more confident and independent so that they can participate in certain activities. Dr. Nilesh Satbhai will examine many things when determining the treatment plan, which includes:
The outlook for treatment depends on the type and complexity of the difference. If the hand difference is an isolated occurrence (not associated with any underlying condition), the outcome is generally good. Most children learn to adapt to their differences. If the hand difference is a part of a syndrome, the outcome depends on the type and severity of the condition.
Treatment cannot completely “cure” a hand difference, but it can help to improve the child’s ability to function with the difference.
Syndactyly is the most common congenital hand difference. Syndactyly is an unusual connection of the fingers to one another. In babies who are born with syndactyly, their fingers are webbed or fused together because they did not separate during normal development. The condition has different types, including:
Simple syndactyly: In this type, the fingers are joined by either skin tissue or other soft tissue, which may appear fused or webbed. The webbing can either be:
Complex syndactyly: In this type, the bones of the fingers are fused/clubbed together. This type of syndactyly is difficult to treat because, in addition to bone, the fingers may also share nerves, a nail, muscles, tendons, and blood vessels.
Syndactyly often runs in families (hereditary), and it can occur alone or as part of a medical condition such as Apert syndrome or Poland syndrome.
Syndactyly is generally treated with the surgical separation of webbed or fused fingers. In this procedure, Dr. Nilesh Satbhai will make an incision in the webbing/fusion and then divide the tissue that is keeping the fingers together. The skin is then closed with stitches, and a splint or cast may be applied to support the fingers during healing.
After surgery, the child will need to undergo physical therapy to improve the range of motion and function.
Polydactyly means the presence of one or more extra fingers or thumbs on the hand. An extra finger might be small and nonfunctional, which is made of only skin and soft tissue or may be fully formed with bones of its own. Mostly, an extra finger is present on the thumb or little finger. Rarely, an extra finger can be found in between the other fingers. Polydactyly also runs in families (hereditary) and is sometimes associated with other medical syndromes or conditions.
Thumb (radial) polydactyly: Thumb or radial polydactyly refers to when there are multiple thumbs present on one hand.
Ulnar polydactyly: Ulnar polydactyly is when there are multiple small fingers or digits on the side of the hand next to the pinky or little finger.
Polydactyly treatment involves the surgical removal of the extra fingers. In this surgery, Dr. Nilesh Satbhai will make an incision over the finger and then remove the extra digit. After the surgery is completed, the skin will be closed with stitches. A splint or cast may also be applied to support the fingers during healing. The child will then need to undergo physical therapy to improve the range of motion and function.
A radial club hand is a deformation of the thumb side of the arm. It causes a shortening and curving of the forearm, giving it an appearance similar to that of a J-shaped club. The thumb might be small or non-existent.
The surgical correction of radial club hand is performed in phases. This strategy allows your child to heal and recover from one surgery before undergoing another. Additionally, some operations are best performed when the patient is a certain age.
Dr. Nilesh Satbhai may recommend the following procedures for the correction of radial club hand:
Stretching the soft tissues of the wrist with an external fixator: This surgery is usually performed when the child is 2 years old. In this procedure, a fixator (a metal frame or bar) is surgically attached to the forearm and hand bones. This allows the soft tissues to be gradually stretched. This process is called “distraction.” Distraction of soft tissues is a lengthy process. The usual time that the fixator is on the arm is between 8 to 12 weeks.
Re-positioning of the hand: During this procedure, the fixator will be removed and a tendon transfer will be performed to set the new position of the hand. A tendon transfer is the procedure of taking a tendon from another area of the body and connecting it to a different bone. K-wires will be used to hold the wrist in position, and after the removal of the K-wires, the arm and hand will be splinted for protection and support.
Pollicization: Pollicisation is a surgical procedure where a thumb is created from an existing finger. In this procedure, Dr. Nilesh Satbhai will move the index finger to the position of the thumb.
Lengthening of the forearm: In this procedure, the forearm is gradually lengthened using an external fixator.
Thumb hypoplasia is a condition where the thumb is undersized or underdeveloped. Thumb aplasia is a condition where the thumb is completely missing or absent.
Dr. Nilesh Satbhai will perform pollicization to reconstruct the thumb. In this procedure, the index finger is moved to the position of the thumb to create a functional thumb. After surgery, a splint or cast will be applied to support the finger during healing. The child will then need to undergo physical therapy to gain motion and function in the new thumb.
Brachial plexus birth palsy is a condition that occurs when the nerves of the brachial plexus (the nerves that innervate the arm and hand) are damaged during birth. This can cause paralysis or weakness of the arm.
Dr. Nilesh Satbhai will generally recommend the following surgical procedures to treat brachial plexus birth palsy:
Nerve transfer: In this procedure, a healthy nerve is connected to the damaged nerve. This can help the damaged nerve regrow and heal.
Nerve graft: In this procedure, a healthy nerve is taken from another area of the body and transplanted to the area of the damaged nerve. This allows the damaged to heal.
Tendon transfer: In this procedure, a healthy tendon is attached to the damaged tendon. This helps to restore muscle movement. After the surgery, Dr. Nilesh Satbhai will apply a splint or cast to the arm to protect it during healing. The child will then need to undergo physical therapy to regain function in the arm.
Congenital lymphoedema is a condition where there is an abnormal accumulation of lymph fluid in the body, causing swelling in the affected area.
If surgical intervention is required for congenital lymphoedema, Dr. Nilesh Satbhai will perform vascularized lymph node transfer, where lymph nodes are taken from one part of the body and surgically transferred to the affected area to rebuild the failed system.
There are many different types of congenital hand differences, and in some extreme cases, surgery may be required to reconstruct the fingers, thumb, or other parts of the hand or upper extremity. Dr. Nilesh Satbhai is a highly skilled and experienced surgeon who has extensive experience in performing these types of surgeries.
In this procedure, the bones, joints, muscles, tendons, and nerves of the damaged or missing part of the hand are reconstructed. This can be done by using tissue from another area of the body or by using artificial implants.
After the surgery, Dr. Nilesh Satbhai will apply a splint or cast to the reconstructed part of the hand to protect it during healing. The child will then need to undergo physical therapy to regain function in the reconstructed part of the hand.
Nonsurgical treatment for congenital hand differences often includes the following:
Physical therapy: Certain exercises that can strengthen the hand and arm to improve the wrist and finger motion.
Occupational therapy: Daily exercise and training can prevent stiffness in the hand/arm which will improve other skills such as handwriting, that are necessary for daily activities.
Adaptive or assistive devices: By use of specialized devices, eating, dressing, and other daily activities can get easier.
Prosthetics: Use of artificial devices to replace or augment missing parts or limbs.
The cost of congenital hand differences treatment in Mumbai will vary depending on the cause and severity of the congenital hand difference, as well as the type of congenital hand differences treatment performed. Dr. Nilesh Satbhai will provide you with a detailed estimate of the cost of your congenital hand differences treatment during your consultation.Book Appointment
In general, the goal of congenital hand differences treatment is to improve the function and appearance of the affected hand or arm. Depending on the procedure performed, this may include increasing the range of motion, repairing damage to bones or joints, correcting deformities, or improving the appearance of the hand.
Anyone who is considering undergoing treatment for congenital hand differences should be aware of the potential risks involved. While the vast majority of procedures are successful, there is always a risk of complications such as nerve injury, infection, and bleeding. In addition, the treated area may become stiffer than it was before, which can limit mobility. However, with modern techniques and experienced surgeons like Dr. Nilesh Satbhai , the risks of congenital hand difference treatment are minimal.
MBBS, MS, MCh