Congenital Hand Disorders

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What are congenital hand disorders?

Child’s hand with some fingers joined and an extra finger on the outside of their little finger.

Having joined fingers and having extra fingers are common congenital hand disorders.

When a baby is born with a hand that isn’t typical, doctors call the condition a congenital hand disorder or congenital hand difference. “Congenital” means “present at birth.”

For some reason, the baby’s hand didn’t form the usual way while they were in the womb. Their hand may look only a little different than usual, and it may work typically or nearly typically. Or it may be quite different from a usual hand, with extra or missing fingers or other differences. In order to use the hand well, the child may need surgery, , a or other treatments.

Types of congenital hand disorders

Two of the most common congenital hand disorders are polydactyly (extra fingers) and syndactyly (joined fingers). Most children with these conditions have no other health problems.

Some hand differences are part of a more complex condition:

Symbrachydactyly may also affect the forearm.
Arthrogryposis and amniotic band syndrome are conditions that may affect a baby’s hands and arms along with other parts of their body.

What causes congenital hand disorders?

Parents often wonder why their baby’s hand isn't typical. Most often healthcare providers cannot tell what caused a congenital hand disorder. These hand differences are rarely caused by something the parents did or didn’t do.

Congenital Hand Disorders Care at Seattle Children's

Seattle Children’s Hand and Upper Extremity Program provides care for babies, children, teens and young adults from birth to age 20 with conditions that affect their hands or arms.

What are the symptoms of congenital hand disorders?

Symptoms of congenital hand disorders may range from mild to serious. They may include:

Extra, missing, short or joined fingers.
Hands that are not as developed as usual or are not the usual size.
Hands that are not in the usual position or cannot move in the usual ways.
For some children, a hand difference is only 1 feature of a more complex condition or syndrome. These children will have other signs and symptoms.

How are congenital hand disorders diagnosed?

If your child is born with a congenital hand disorder, the doctor will examine them carefully. During the exam, the doctor will check for other signs to tell if your child has a more complex condition.

Your child may need an to see if there are differences in the bones in their hand. To help diagnose your child’s condition, they may need other imaging studies, such as an .

If the doctor thinks your child might have other genetic problems, your child might have tests to check their .

How are congenital hand disorders treated?

Congenital hand disorders can vary widely, so there’s no single treatment approach. Your child’s treatment will be custom-made for them.

The main goal of treatment is to give your child the best possible use of their hand. Your child’s team will also pay attention to how your child’s hand looks and if they can give it a more typical look.

For most children, treatment for congenital hand disorders involves 1 or more of the following:

Surgery to remove extra fingers, divide joined fingers or reconstruct missing parts of the hand
Occupational therapy to help with stiffness or scarring and improve a child’s skills, such as writing and feeding themselves
Splinting and casting to hold the hand in 1 position, often while it heals after surgery
Adaptive devices to help your child do what they want and need to do with their hands
Prosthetic devices to replace missing parts

Your child’s team can explain all your child’s treatment options, which options the team recommends and why.

Some hand differences need treatment in the early months or years after birth and then don’t need any other treatment later. Other differences may need more treatment as your child grows. Ask your child’s team about the short-term plan, the long-term plan and what to expect.

Why choose Seattle Children’s for congenital hand disorders treatment?

Seattle Children’s Hand and Upper Extremity Program treats children with congenital hand disorders. Each year we see many babies with these conditions in our clinics. Our team is experienced in the range of treatment options your child may need. We create a treatment plan custom-made for your child to get the best results for them.

The hand experts you need are here
- Your child’s team includes doctors, surgeons, , and nurses from Orthopedics and Sports Medicine as well as Plastic Surgery if needed.
- For many of our patients, treatment means surgery — sometimes highly complex surgery, such as . Our surgeons are experienced at doing these surgeries in children. We have surgeons with expanded fellowship training in upper extremity surgery.
- If your child needs occupational therapy to gain the best use of their hands, we have the largest team of occupational therapists in the Pacific Northwest who specialize in the care of babies, children, teens and young adults.
- Some children do best with a prosthesis to replace missing parts of their hand. We have orthotics and prosthetics services onsite at Seattle Children’s.
- Complex conditions that affect the bones, muscles and of your child’s hand may affect other parts of their body too. That’s why we connect you with the many types of Seattle Children’s experts your child needs.
Care from before birth through young adulthood
- We specialize in caring for kids. This means our experts have the knowledge, training and skills to treat the youngest patients, including babies and young children with congenital hand disorders. At Seattle Children’s, your child’s team has special training in the medical, surgical, emotional and social needs of young people.
- If your child is diagnosed with a congenital hand disorder before birth based on an , we offer prenatal consultations to talk with you about your baby’s condition.
- Babies and children are still developing. When we evaluate your child’s condition, plan their treatment and provide their care, we carefully consider their growth. We think about how growth may affect your child’s hands over time. We also consider how their condition and treatment may affect the rest of their development and health.
- We have the largest group of pediatric radiologists in the Northwest. If your child needs imaging that uses radiation, we use the lowest amount possible (PDF) to make the best image. We have a low-dose radiation X-ray machine, called the EOS. It makes safer full-body images.
Support for you and your family
- We know it can be stressful to have a child with a hand difference and to find the treatment they need. Everyone at Seattle Children’s works to make your experience here as easy as we can on your whole family.
- Your child’s team does more than plan and provide care for your child. We also make sure you and your child understand your child’s condition and treatment options.
- Seattle Children’s supports your family with a range of resources. Our Child Life specialists, Family Resource Center and Guest Services are here to help.
Research to improve care
- Seattle Children’s takes part in the CoULD Registry for congenital upper limb differences. A registry is a place where researchers keep information about people who have a certain condition so they can learn more about it. CoULD connects researchers from children’s hospitals around the country to study treatments and improve life for kids born with arms and hands that aren’t typical.
- Learn more about current orthopedics research at Seattle Children’s.