In this section
When your child has been born with a
congenital hand difference or has injured themselves parents need to be
reassured that the care they receive is world class and that the management of
the hand problem is based around the considerations for the child and the
The Melbourne Paediatric Hand Centre
based at the Royal Children’s Hospital in Melbourne has become known as one of
the elite centres for the management of children with hand conditions. It
attracts patients from all over Australia and there are enquiries to the centre
about children with hand problems from many parts of the world.
Most parents are commonly surprised
following the birth of their child that they have a congenital hand
difference. The majority of congenital hand issues are not diagnosed prenatally
by ultrasound and this leaves parents in a difficult situation not knowing what
the future holds for their newborn child. Children who are born with a
congenital hand difference are not the same as adults who end up with a hand
problem following an injury. New parents of children with congenital hand
differences commonly try to imagine what it would be like having a particular
type of congenital hand anomaly. These children have been born with their hand
difference and will grow from day one with their particular hand and are able
to develop patterns of function that will enable them to grow up to lead
fulfilling and fruitful lives without significant impairment to their function.
The objective of surgery for
congenital hand differences is to maximise function, completing surgical
reconstructions as required usually by the time the child reaches school
Development of the limbs in a baby occurs very early, during
the 3rd and 8th week of the pregnancy. There is an elaborate interplay between
the cells of the developing limb and why there is an alteration in these
processes that then results in a congenital hand difference is largely unknown.
Some patients will have a family history of hand anomalies but the majority
There is no evidence that anything a mother does
during pregnancy causes congenital hand defects.
A large study in America has shown that the incidence of
congenital hand anomalies is 1 in 626 live births but regional and ethnic
differences occur. The most common hand differences are camptodactyly (bent
fingers), syndactyly (joined fingers) and polydactyly (extra digits).
Occasionally congenital hand differences (5%) can be part of a broader
underlying congenital syndrome.
As soon as possible following the diagnosis of a congenital
hand difference in a child so that accurate information can be given and a
program of management can be outlined for them.