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Congenital Clinic for the Special Hand
The Curtis National Hand Center holds a free congenital clinic each month. Parents may make an appointment to have their child evaluated by a member of the hand team.
Congenital Differences
Congenital differences of the hand and arm are variations from the normal that are present from birth. Common differences include a smaller arm with muscles, bones, and/or joints that have not formed normally. The arm may be bowed (e.g. radial club hand); various parts of the arm may not form at all (e.g. transverse deficiencies); fingers may be joined together (syndactyly); or there may be extra fingers (polydactyly).
Causes
In some cases, the causes of congenital differences can be explained, but in others the answers are not as clear. A great majority of malformations arise either at the moment of conception, or during the second month of fetal development, as the human arm bud appears and fully develops between the 25th and 50th day after fertilization. Some congenital problems are inherited and may skip generations in passing the trait. There are also genetic differences with non-genetic causes related to certain drugs and various chemotherapy agents. It should be noted that other systems in the body may be affected in conjunction with certain types of congenital differences. These may include heart problems, other musculoskeletal problems, and/or blood disorders. The physician will help you find answers to your questions as to what happened and why, and may refer you to a geneticist.
Treatment
The goal for the child with a hand or arm congenital anomaly is to allow the child to function as normally as possible. It is normal for the parents of babies with birth defects to go through a period of shock, anger, and guilt. Counseling may be necessary to help parents cope emotionally, and accept what has happened. The child will need strong and consistent loving support from the parents if the congenital difference is to be accepted and emotional stability achieved. Physical treatment options include therapy, the use of prostheses, and surgical intervention. An individualized plan of care will be developed for each patient. If the child is able to functionally compensate for his or her deformity, surgery may be unnecessary. In cases of constriction band syndrome, where blood supply to the part is compromised; or in syndactyly, where fingers are joined together and separation is needed for proper growth, early surgical intervention may be necessary. The hand team will discuss the treatment goals and options with the family and the child, if he or she is old enough to understand. With the hand team and family working closely together, the child’s needs will be met and all the challenges he or she faces will be easier to overcome.
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