Congenital & Acquired Hand Deformities

Congenital and acquired hand deformities refer to abnormalities affecting the structure and function of the hand and wrist. These conditions may be present at birth (congenital) or develop later due to trauma, arthritis, or disease (acquired). Orthopaedic surgeons specializing in hand surgery focus on correcting these deformities to improve hand function, mobility, and appearance.

Congenital Hand Deformities

Congenital hand deformities occur due to abnormal fetal development and can affect bones, muscles, tendons, ligaments, or nerves.

Common Congenital Hand Deformities

• Syndactyly (Fused Fingers): Fingers are webbed or fused together due to incomplete separation during development.
• Polydactyly (Extra Fingers): A person is born with one or more extra fingers, which may be fully developed or partially formed.
• Thumb Hypoplasia: The thumb is underdeveloped or absent, making grasping difficult.
• Radial Club Hand: A condition where the radius bone is missing or underdeveloped, causing wrist deviation.
• Camptodactyly: A condition where a finger (often the little finger) is permanently bent due to abnormal tendon or muscle development.
• Cleft Hand (Ectrodactyly): A V-shaped split in the hand due to missing central fingers, leading to a claw-like appearance.

Treatment for Congenital Deformities

• Surgical correction: Separation of fused fingers, removal of extra digits, or thumb reconstruction.
• Tendon transfers: To restore movement in weak or absent muscles.
• Splinting & therapy: Improves function and prevents stiffness after surgery.

Acquired Hand Deformities

Acquired deformities develop after birth due to injury, disease, or repetitive stress.

Common Acquired Hand Deformities

Post-Traumatic Deformities:

• Malunion or nonunion fractures
• Tendon injuries leading to claw hand or loss of motion
• Joint contractures from burns or scarring

Arthritic Deformities:

• Rheumatoid Arthritis: Causes joint deformities, swan-neck deformity, and ulnar drift.
• Osteoarthritis: Leads to bone spurs, joint stiffness, and Heberden’s/Bouchard’s nodes.

Neuromuscular Conditions:

• Dupuytren’s Contracture: Thickening of the palmar fascia causing fingers to curl inward.
• Claw Hand Deformity: Often due to ulnar nerve damage, resulting in curled fingers.
• Trigger Finger: A condition where a finger gets stuck in a bent position due to inflamed tendons.

Treatment for Acquired Deformities

• Surgical Reconstruction: Joint replacements, tendon repairs, or contracture release.
• Physical Therapy & Splinting: Improves mobility and prevents further deformity.
• Medication & Injections: To manage pain and inflammation in arthritic conditions.

Rehabilitation & Recovery

• Post-Surgical Therapy: Strengthens muscles and restores function.
• Assistive Devices: Custom braces or splints for better hand use.
• Long-Term Follow-Up: To monitor growth and hand development in children with congenital deformities.