CONGENITAL   DEFECTS 

OF   THE    HAND

    Congenital deformities of the hand-that is, deformities with which a child is born-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-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.

     Recovery and rehabilitation. Since the hand is a very sensitive part of the body, you may have mild to severe pain following surgery. Your surgeon can prescribe injections or oral medication to make you more comfortable. How long your hand must remain immobilized and how quickly you resume your normal activities depends on the type and extent of surgery and on how fast you heal. To enhance your recovery and give you the fullest possible use of your hand, your surgeon may recommend a course of rehabilitation (physical and occupational therapy) under the direction of a trained hand therapist. Your therapy may include hand exercises, heat and massage therapy, electrical nerve stimulation, splinting, traction, and special wrappings to control swelling. Keep in mind that surgery is just the foundation for recovery. It's crucial that you follow the therapist's instructions and complete the entire course of therapy if you want to regain the maximum use of your hand.

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