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Congenital Hand Reconstruction

What is a Congenital Hand Difference?

A congenital hand difference is a hand that is abnormal at birth. One in 20 children is born with some hand difference. These can be either major or minor. Some possible differences include missing parts (failure of formation), webbed or fused parts of the hand (failures of separation), extra parts in the hand (duplication), or parts that are larger or smaller than normal.

Examples of common congenital hand differences include:

  • Webbed fingers, called syndactyly
  • An extra small finger, called polydactyly
  • An extra thumb, called radial polydactyly


During fetal development, the upper limb is formed between four and eight weeks during pregnancy. Many steps are needed to form a normal arm and hand. If any of these steps fail, then a congenital hand difference can result. Some of these differences have genetic causes, but many of these differences occur without a known cause. Research is being done to try to understand these processes.

Signs and symptoms

Some congenital hand differences are easy to identify, but others can be more difficult because they have more than one feature. Some differences appear similar but have different diagnoses. It is important that your child be evaluated by a hand specialist to help determine if any treatment is needed. Dr. Brown, a hand specialist, may refer you to a genetics specialist to help make an overall diagnosis for your child.


Webbed fingers are usually separated with surgery, and extra fingers can be surgically removed. Sometimes the remaining finger or thumb requires surgery for reconstruction. All babies born with congenital hand differences should have a complete assessment by a hand specialist who treats these conditions. Sometimes a child may need hand therapy. Sometimes, no treatment is necessary.

Dr. Brown is board certified in both hand and Plastic surgery with long experience in correction of congenital hand anomalies. He has participated in international courses instructing other surgeons in the treatment of congenital hand anomalies.