EARLY TREATMENT. BETTER OUTCOMES.
Specialist surgical treatment for children born with hand differences — giving them the best possible functional and cosmetic outcome at the age when treatment is most effective.
ABOUT THESE CONDITIONS & TREATMENT
Congenital hand conditions are present from birth and encompass a wide spectrum of abnormalities: fingers that are fused together, extra or missing digits, underdeveloped or absent thumbs, immobile tendons, trigger fingers, and malformed nerves or blood vessels. These conditions can impair hand function, restrict normal development, and affect a child’s ability to perform everyday tasks as they grow. The good news is that the majority of congenital hand abnormalities can be surgically corrected, often with excellent functional and cosmetic results.
Syndactyly — in which two or more fingers are fused together — is one of the most common congenital hand conditions. Surgical correction separates the fingers and uses skin grafts to cover the newly created surfaces, restoring independent movement. Where the underlying bones are also fused, the procedure is more complex, but correction is still possible in most cases. Thumb hypoplasia or aplasia — where the thumb is underdeveloped or absent — can also be addressed surgically, with the goal of restoring or constructing a functional thumb that the child can use throughout life.
The timing of surgery is important: most congenital hand procedures are performed in early childhood, when the hand is still developing and adaptation is most effective. We assess each child individually and recommend the most appropriate surgical approach for their specific anatomy and needs. In some cases, we may refer families to a highly specialised centre with additional expertise in complex congenital reconstruction — this is always done in your child’s best interest and we support you through that process.
UNDERSTANDING THE CONDITIONS
The spectrum of congenital hand differences is wide — most can be surgically corrected with a good outcome.
FUSED DIGITS
The most common congenital hand condition — two or more fingers joined by skin (simple) or by bone (complex). Surgical separation restores independent finger movement using skin grafts to cover the newly created surfaces. Early correction is recommended to prevent tethering as the hand grows.
EXTRA OR MISSING DIGITS
Polydactyly describes an extra digit — ranging from a small skin nubbin to a fully formed finger with bone. Surgical removal produces a hand with normal digit number and appearance. Hypoplasia refers to a finger or thumb that is smaller and less developed than normal. Aplasia is complete absence. Both can often be surgically addressed or enhanced.
THUMB & TENDON CONDITIONS
An underdeveloped or absent thumb severely limits pinch and grip function. Surgical reconstruction or thumb creation (pollicisation) can restore meaningful thumb use. Congenital trigger finger, immobile tendons, and malformed nerves or blood vessels can also be corrected surgically in most cases, restoring movement and function to the affected hand.
PROCEDURE AT A GLANCE
General parameters — specific details confirmed at your child's consultation.
Surgery Time
Anaesthesia
Hospital Stay
Hands Wrapped
First Follow-up
The exact surgical approach — augmentation, reduction, lift or combination — is determined at consultation based on your individual anatomy and goals.
RECOVERY TIMELINE
Days 1–7
Both hands are wrapped immediately after surgery to protect the wounds and prevent the child from disturbing them. Your first follow-up is one week after the procedure, where the dressings are reviewed and the healing is assessed. Parents receive full guidance on home care before discharge.
Weeks 2–4
The wrapping is removed at two weeks. Depending on the procedure, splinting may continue to protect and support the healing tissue. Wounds are reviewed and the child’s progress is assessed. Gentle use of the hand is gradually reintroduced as healing allows.
Months 1–3
Occupational therapy or paediatric hand therapy is often recommended to support the child in building strength, coordination and confidence in using the hand. Children adapt to improvements in hand function remarkably quickly at this age, particularly when intervention is well-timed.
Months 3–12+
The hand continues to develop as the child grows. Results typically improve progressively as the child learns to use their fingers fully. Long-term follow-up ensures that function and appearance are developing as expected, and that any further refinements are planned at the right time.
WHAT TO EXPECT
The results of congenital hand surgery are often remarkable, particularly when treatment is well-timed. Most families experience:
WHY SURGICAL TREATMENT
The early years of childhood are when hand development is most active and the nervous system most adaptable. Surgery during this period allows the brain and hand to develop together, producing better functional outcomes than intervention in later life.
Beyond function, surgical correction produces a hand that looks considerably more typical — reducing self-consciousness and social difficulties as the child grows, starts school, and takes part in activities with other children.
No two congenital conditions are identical. The surgical plan is designed around your child’s specific hand anatomy, the nature of the condition, and the outcome that will best serve their long-term function and development.
For highly complex conditions requiring additional subspecialist expertise, we will refer you to the most appropriate specialist centre. This transparency is part of our commitment to acting in your child’s best interest at every stage.
THE DEVELOPMENTAL WINDOW
The early years of a child’s life represent a critical window for hand development. The brain is at its most neurologically plastic, meaning it adapts most readily to new sensory input and motor patterns. When surgical correction restores normal digit anatomy during this period, the child’s brain and nervous system integrate the improvement far more completely than would be possible later in life.
There is also a practical developmental reason: fused fingers of different lengths, if left uncorrected, will tether each other as the hand grows — leading to progressive deformity that becomes increasingly difficult to correct. Addressing these conditions early prevents a straightforward procedure from becoming a complex one.
Optimal Treatment Timing
“
Our daughter was born with syndactyly on both hands. The surgery changed everything for her. She’s six now and you would never know — her hands work beautifully and she loves painting.
“
We were frightened about our son having an operation so young. Prof. Hindocha was calm and clear with us at every stage. The outcome was far beyond what we had hoped for.
“
My son was born with an extra finger. The correction was done before his first birthday. He’s ten now and has full function — it never holds him back at all.
WHAT SURGERY INVOLVES
Congenital hand surgery is performed under general anaesthesia, so your child is fully asleep throughout the procedure and experiences no discomfort. Most procedures are day cases — your child goes home the same day once the anaesthetic has fully worn off and they are eating and drinking normally.
After surgery, both hands are wrapped in soft dressings to protect the wounds and prevent your child from disturbing them — a normal and necessary precaution. A first follow-up at one week reviews the healing and provides guidance on the next steps. Occupational therapy or hand therapy typically follows to support your child in developing full use of their hand during the recovery period.
WHEN TO SEEK ASSESSMENT
An early specialist assessment is recommended for any child born with a hand difference. You should seek an opinion if your child has any of the following:
EXPLORE FURTHER
A full range of hand surgery available with Prof. Hindocha.
HAND SURGERY
A finger that catches or locks when bent — can occur in children as well as adults.
HAND SURGERY
Compression of the median nerve causing tingling, pain and loss of hand function.
HAND SURGERY
Progressive thickening of the tissue beneath the palm causing fingers to curl inward.
DON'T WAIT
Early assessment leads to better outcomes.
The earlier a congenital hand condition is assessed, the more options are available and the better the likely outcome. A consultation with Prof. Hindocha gives you a clear picture of your child’s condition, the treatment options, and the right timing for intervention — with no obligation to commit on the day.
FREQUENTLY ASKED QUESTIONS
Straightforward answers to what families most want to know.
