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Hand Deformities

Synonyms: Hand Defects, Hand Deformity

What are Hand Deformities?

Hand Deformities or Hand Defects are deformities of the hand or any part of the hand i.e. fingers, thumb etc.

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What are the different kinds of Hand Deformities?

Hand Deformities can be:

  • Congenital Hand Deformities - This kind of Hand Deformities are present at birth. The Congenital Hand Deformities may be due to some of the following problems:
    • Developmental problems - These are Hand Deformities due to problems while the baby is developing in the womb.
      • Radial and Ulnar ClubHand Deformity - Radial Club Hand Deformity involves all the tissues i.e. bones, muscles etc on the thumb side of the arm and the hand. There may be a small or absent thumb and the muscles on that side of the hand may be underdeveloped. Ulnar Club Hand Deformity involves underdevelopment of bones and muscles on the ulnar or the little finger side of the arm and hand.
      • Thalidomide related deformity of limbs - Thalidomide is a drug which when taken during pregnancy causes failure of formation of both upper and lower limbs in part or completely.
    • Parts of the hand that fail to separate - In this kind of Hand Deformity, the soft tissues or the bones of the fingers are joined together.
      • Syndactyly - Syndactyly is the most common Hand Deformity where two fingers are fused together.
        • Simple Syndactyly - In this Hand Deformity, there is fusion of soft tissues only between the 2 fingers.
        • Complex Syndactyly - In this kind of Hand Deformity, the bones and the soft tissues of the two fingers are joined together.
    • Extra finger(s) - In this type of Hand Deformity, there is duplication of the finger(s) (polydactyly) especially the little finger which is most commonly affected.
      • Polydactyly - There are 3 kinds of polydactyly Hand Deformity:
        • Type 1 polydactyly - In this Hand Deformity, an extra digit is attached by skin and nerves
        • Type 2 polydactyly - In this Hand Deformity, an extra digit with normal parts is attached to the bone or joint of the little finger.
        • Type 3 polydactyly - In this Hand Deformity, there is an extra metacarpal bone in the hand to which the extra digit is connected. The extra digit has all the normal parts of a digit.
    • Undergrowth of tissues of a digit - In this condition, the Hand Deformity manifests itself as a thumb or finger with small bones and muscles.
      • Brachydactyly - In this kind of Hand Deformity, the thumb and fingers are unusually short due to short bones and underdeveloped soft tissues
    • Overgrowth of tissues of a digit - This Hand Deformity normally occurs after amputation of a finger or a thumb.
      • Macrodactyly - This kind of Hand Deformity normally affects the thumb or the index finger. In this situation, the bone of the forearm may also be involved.
    • Constriction Band - This kind of Hand Deformity is usually associated with other congenital abnormalities like Cleft Lip, Cleft Palate. In this condition, a constricting band of tissues is formed around a finger (ring constriction) or your arm. In this Hand Deformity, the constricting band of tissues may affect the blood flow and thus the growth of the tissues.
  • Acquired Hand Deformities - This kind of Hand Deformities are acquired as a result of injury or disease. Some of the causes of acquired Hand Deformities are as follows:
    • Rheumatoid Arthritis - Rheumatoid Arthritis causes Hand Deformities that most commonly affect the wrist and the small joints of the hands. These Hand Deformities are commonly referred to as Swan neck and boutonniere Hand Deformity.
    • Osteoarthritis - This condition usually caused Hand Deformities and disfigurement of small joints of the fingers.
    • Carpal Tunnel Syndrome - In this condition there is compression of the median nerve in the wrist which may result in Hand Deformities like weakness and wasting of hand and finger muscles.
    • Burn Contractures
    • De Quervain's tenosynovitis - In this Hand Deformity, there is inflammation of the tendon on the side of the wrist at the base of the thumb.
    • Dupuytren's Contracture - In this Hand Deformity, the skin and underlying tissue on the palm form thick, scar-like tissue which may extend into the fingers, pulling them toward the palm and restricting movements of hand as a whole.
    • Sports Hand Injuries - Severe sports injuries of the hand may cut the tendons, nerves, blood vessels, fracture bones, tear the ligaments of the joints resulting in severe Hand Deformities.
    • Amputation - Accidental amputation of fingers may result in severely limiting Hand Deformities.

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What are the different types of surgeries to treat Hand Deformities?

  • Reduction and Fixation of a broken bone - This can be open or closed depending on the injury that may have resulted in Hand Deformities. A combination of open and closed approach is commonly used which may include internal fixtures, such as wires or rods for realignment of the broken bones followed by immobilization of the hand with a splint or a cast until the fracture heals.
  • Drainage and Debridement - This can be performed surgically when there is an infection and formation of an abscess (localized collection of pus) in the hand. In case of severe Hand Injuries, the wound can be debrided to promote faster healing.
  • Micro-Surgical Replantation - This procedure is performed to re-attach the finger(s), part of finger(s) or hand by very intricate and precise (Micro-surgical) methods.
  • Skin Grafting - In this procedure, skin is taken from a healthy part of the body and is used to replace the skin where it is missing on the hand. The most common type of Hand Deformity where Skin Grafting is used is amputation of a finger(s) or part of finger(s) and Burn Deformities of the hand.
  • Skin Flap - This procedure is similar to Skin Grafting except that it is used when there is damage to deeper tissues of the hand. In Skin Flap procedure, the skin which is taken from another area of the body has blood vessels, fat and muscles attached to it to compensate for the loss due to injury.
  • Tendon and nerve repairs - Hand Injuries involving the tendons and nerves are quite challenging to repair due to their complex structure and location. Hand Deformities from injured tendons and nerves include decreased movement, numbness, weakness etc.
  • Arthroplasty or Joint Replacement - This surgical treatment is used for Hand Deformities caused by severe arthritis of the joints of the hand.
  • Fasciotomy - In this procedure surgical incisions are made in the fascia to release pressure on the nerves and blood vessels. Overgrowth of fascia tissue may result from injury to the hand or wrist. This may result in Hand Deformity and loss of function due to pressure on the arteries, nerves and veins.

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Who is an ideal candidate for surgery to correct Hand Deformities?

If you have Hand Deformities due to any of the above conditions and are in good health generally and can withstand and the pain and discomfort that might be present in the post-operative period, then you are an ideal candidate for reconstructive surgery to correct Hand Deformities. Children with Congenital Hand Deformities should have a repair surgery as soon as your surgeon considers them to be old enough to under go the procedure provided they are in good health.

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What does the surgery to correct Hand Deformities involve?

Most of these surgical procedures are conducted under local anesthesia with sedation in a hospital or a medical center. However, surgery for joint replacement may be performed under general anesthesia. Depending on the extent of surgical repair, it may take any where from 45min - 3hrs. You will spend the next couple of hours in the recovery room under observation for immediate post-operative complications. Make sure that you arrange for someone to drive you home and help you around the house for the next few days following the surgery to correct Hand Deformities.

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What are the pre-operative preparations for surgery to correct Hand Deformities?

Hand Deformities are most commonly repaired under local anesthesia with sedation however, in some cases general anesthesia may be used for procedures that might require manipulation of deeper tissues. A pre-operative consultation may comprise of a thorough examination and assessment of the Hand Deformities. Please make sure to inform your surgeon about your health condition, any prescription or non-prescription medication including vitamin, mineral and herbal supplements that you might be taking. Make arrangement for someone to help you around the house after your surgery to repair Hand Deformities until you can resume your daily activities.

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What to expect during the post-operative period following surgical repair of Hand Deformities?

There might be moderate degree of pain after your surgery for Hand Deformities. Your hand may be immobilized in a sling or a splint for a few weeks. In order to regain full range of movement and function, your surgeon might recommend physical and rehabilitation therapy. Your regimen of therapy may include hand exercises, heat and massage therapy, electrical nerve stimulation, splinting, traction, and special wrappings to control swelling. Do not over use your hand or perform strenuous activities following surgical repair of Hand Deformities. Make sure you keep your dressing clean and dry. Vigilant post-operative care is very critical for speedy recovery and restoration of normal function of your hands.

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What is the outcome of surgical repair of Hand Deformities?

The outcome of surgical repair of Hand Deformities is pretty good. Most of the patients are quite satisfied and can regain 98% of the movement and function of their hand. Like most cosmetic and re-constructive surgeries, surgeries to repair Hand Deformities have a good success rate when performed by experienced and qualified surgeons. The goal of the surgery is not only to improve the function of your hand, it is also to improve the appearance of your hand.

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B. R . A . N . D . of surgical repair of Hand Deformities

Benefits of surgical repair of Hand Deformities

  • Hand is a very important part of the body. Surgical repair of Hand Deformities, whether congenital or acquired not only restores it's function of your hand like grasp and pinch, it also improves the movements of your fingers and wrist. Surgical repair of Hand Deformities also improves it's appearance and establishes a balance between other parts of your body.

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Risks of surgical repair of Hand Deformities

  • Bleeding
  • Infection
  • Delayed or incomplete healing
  • Loss of feeling or numbness

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Alternatives to surgical repair of Hand Deformities

  • Physical therapy and pain medication can provide temporary relief during the waiting period especially for acquired Hand Deformities, there is no other treatment available other than surgical repair to restore function and anatomy of your hand.

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Now or Never

  • Re-constructive surgery is being used worldwide to restore the normal anatomy, function and to enhance appearance of your body. With rapid and accurate evaluation and timely treatment, you can rid yourself easily of serous handicap caused by Hand Deformities. With the availability of sophisticated techniques and expertise, it is possible to get your independence back in just a few easy steps.

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Decision to have surgical repair of Hand Deformities

  • The hand is a very sensitive yet a very critical part of the body. Loss or limitation of function from Hand Deformities can be significantly devastating. With the advent of modern reconstructive surgical techniques, your hand can again be as good as new in no time with minimum scars from your surgical incisions.

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Keywords: Reconstructive Surgery, Club Hand, Thalidomide related deformity of Limbs, Missing Finger, Extra Finger, Fused Finger, Hand Deformity, Syndactyly, Polydactyly, Rheumatoid Arthritis, Osteoarthritis, Carpal Tunnel Syndrome, De Quervain's Tenosynovitis, Sports Hand Injuries, Amputation, Swan Neck Hand Deformity, Butonniere Hand Deformity, Surgical Replantation, Fasciotomy, Bone Reduction & Fixation, Arthroplasty, Joint Replacement

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