Malformations of the hand and wrist

Congenital malformations of the hand and wrist are developmental disorders that occur during pregnancy. These can affect the shape, function or mobility of the hand. Early diagnosis and targeted therapy are crucial in order to maintain the best possible hand function.

Congenital malformations of the hand occur in around 1 in 2,000 newborns. The causes are varied:

Common causes:

• Genetic factors
• Metabolic disorders during pregnancy
• Environmental influences during the early development phase

Frequent malformations:

• Polydactyly (supernumerary fingers)
• Syndactyly (fused fingers)
• Radius aplasia (malformation of the radius)
• Hypoplasia (underdeveloped hand structures)
• Clinodactyly (lateral deviation of a finger)

Typical signs can be

• Changed shape of the hand or individual fingers
• Limited gripping function
• Restricted movement of the fingers or wrist
• Depending on the deformity, possible restrictions in everyday activities

Treatment depends on the type and severity of the deformity:

Conservative therapy:

• Observation for mild malformations without functional limitations
• Targeted physiotherapy and occupational therapy to promote hand function
• Use of customised splints or orthoses

Surgical therapy:

• Separation of fused fingers
• Removal or reconstruction of supernumerary fingers
• Correction of bone malpositions
• Tendon transfers to improve mobility
• Follow-up treatment with individualised rehabilitation

The prognosis for congenital malformations of the hand depends on the type and complexity of the malformation and the timing of treatment. With early and adequate treatment, a significant improvement in function can be achieved in many cases. Conservative measures show good results in milder cases, while more complex malformations usually require surgical intervention.