You are here

Congenital Hand Deformities



  • deformity in radio-ulnar plane, Rx rarely indicated, stretching/splinting ineffective.


  • deformity in A/P plane. Most commonly from anomalous lumbrical and superficialis insertions McFarlane RM, Classen DA, Porte AM, Botz JS:  The anatomy and treatment of camptodactyly of the small finger.  J Hand Surg Am 1992; 17:35-44.
  • RX:frequent stretching with splinting, surgery in deformity >60 degrees
  • Camptodactyly of the of the thumb DIP joint in an infant=locked trigger thumb-classically occurs at 18-24 months.

Kirner’s Deformity

  • volar curvature of distal phalanx, not clinically apparent until 8-12 yrs, usually bilateral

transverse Congenital absence =transverse absence, constriction ring syndrome, symbrachydactyly (unilateral, no foot involvement)

Radial Club hand-50-75% bilateral. Stage I=deficient distal radial epiphysis. Stage II=complete but short/hypoplasia. III=partial aplasia. IV=total aplasia. Humerus often short,  ulna thick 60%normal length. Rx=passive motion, if +elbow motion consider centralization at 6-12months.

Ulnar Club hand-elbow problem. Absent/syndactylized ulnardigits. Stage I=ulnar hypoplasia. II=partial aplasia. Stage III=total aplasia. IV=radiohumeral synostosis. Rx:syndactyl release, varied

Cleft Hand-bilateral, familial, feet, absent metacarpals.  Rx=varied

Radioulnar Synostosis


  • Congenital digital stiffness
  • failure of IP joint development
  • Treatment rarely needed


Flexed thumb=congenital trigger thumb or congenital clasped thumb



most commom congenital hand anomaly. Simple=soft tissue. Complex=bony. Complete=to tip of finger vs Incomplete.5-15-50-30%. Rx=release


Pre-axial Polydactyl=thumb.Wassel classification type IV-duplicated prox phalanx=43%-most common

Post axial =small finger. A=well formed. B=skin tag. Back\white=10\1. Whites need genetic work-up



Thumb hypoplasia

  • classified by Blauth.
  • Type I=small thumb: no treatment.
  • Type II=adduction, floppy, normal skeleton. Treatment=reconstruction
  • Type IIIA=musculotendinous deficiencies, intact CMC joint. Treatment=reconstruction
  • Type IIIB=no CMC joint. IV=MC aplasia. Treatment=pollicization.
  • Type V=complete absence. Treatment = pollicization

Madelungs Deformity

  • disruption of volar ulnar distal radial epiphysis. >radial inclination, ulnocarpal impaction usually in adolescence


The information on this website is intended for orthopaedic surgeons.  It is not intended for the general public. The information on this website may not be complete or accurate.  The eORIF website is not an authoritative reference for orthopaedic surgery or medicine and does not represent the "standard of care".  While the information on this site is about health care issues and sports medicine, it is not medical advice. People seeking specific medical advice or assistance should contact a board certified physician.  See Site Terms / Full Disclaimer