Dramatic advances have been made in treating patients with congenital birth defects of the hand. At the forefront of these advances have been plastic surgeons–specialists whose major interest is in improving both function and appearance.
Plastic surgeons undergo intensive training in hand surgery, and they (along with orthopedic surgeons and general surgeons) treat patients with a wide range of hand problems.
This information is designed to give you a basic understanding of the most common hand problems–what they are, what plastic surgeons can do for them, and the results you can expect. It can’t answer all of your questions since each problem is unique, and a great deal depends on your individual circumstances. Please be sure to ask your doctor if there is anything about the procedure you don’t understand.
If You’re Considering Surgery for Congenital Hand Defects
If you’re considering hand surgery, a consultation with a plastic surgeon is a good place to start. The surgeon will examine you, discuss the possible methods of treatment for your problem, and let you know if surgery is warranted. If it is, the surgeon will discuss the procedure in detail, including where the surgery will be performed (in the surgeon’s office, an outpatient surgery center, or a hospital); the anesthesia and surgical techniques that will be used; possible risks and complications; the recovery and rehabilitation period, and the probable outcome in terms of function and appearance.
Don’t hesitate to ask your surgeon any questions you may have during the initial consultation: including any concerns you have about the recommended treatment and the costs involved. (Since hand surgery is performed primarily to correct physical abnormalities, it usually is covered by insurance. Check your policy or call your carrier to be sure.)
What Are Congenital Hand Deformities?
Congenital deformities of the hand—that is, deformities a child is born with,—can interfere with proper hand growth and cause significant problems in the use of the hand. Fortunately, with modern surgical techniques, most defects can be corrected at a very early age (in some cases during infancy, in others at two or three years of age), allowing normal development and functioning of the hand.
One of the most common congenital defects is syndactyly, in which two or more fingers are fused together. Surgical correction involves cutting the tissue that connects the fingers, then grafting skin from another part of the body. (The procedure is more complicated if bones are also fused.) Surgery can usually provide a full range of motion and a fairly normal appearance, although the color of the grafted skin may be slightly different from the rest of the hand.
Other common congenital defects include short, missing, or deformed fingers, immobile tendons, and abnormal nerves or blood vessels. In most cases, these defects can be treated surgically and significant improvement can be expected.
All Surgery Carries Some Uncertainty and Risk
Thousands of successful hand operations are performed each year. While the procedures are generally safe when performed by a qualified and experienced plastic surgeon, complications can arise.
In all types of hand surgery, the possible complications include infection, poor healing, loss of feeling or motion, blood clots, and adverse reactions to the anesthesia. These complications are infrequent, however, and they can generally be treated. You can reduce your risks by choosing a qualified surgeon and by closely following his or her advice.