"Our chief surgical goals with cleft hand are to close the cleft, optimize the thumb's function to preserve or enhance grasping, pinching and releasing movements, and improve the hand's appearance."
-Peter M. Waters, MD, clinical chief, Orthopedic Center; director, Hand & Orthopedic Upper Extremity Program; director, Brachial Plexus Program, Boston Children's Hospital
At Children’s Hospital Boston, we understand how concerned you are if your baby was born with a hand deformity called cleft hand. Our Orthopedic Center’s Hand and Orthopedic Upper Extremity Program will approach your child’s condition with care and support—for your child and your whole family.
- A diagnosis of cleft hand means that your child’s hand is missing finger(s) and may have other deformities, some of which can be classified by type. (See Tests for more on classification.)
- Clefts are always central (middle finger[s]) and are usually V-shaped.
- But they can also be on the thumb (radial) side, less commonly little (ulnar) finger side, or in various combinations.
- Cleft hands usually occur on both hands (bilateral).
- But they can also be unilateral, and can include one or both feet.
- The condition is present and visible at birth (congenital).
- There’s a clear genetic basis for typical cleft hands.
- Inheritance of cleft hand is autosomal dominant: This means that if a parent has the condition, the child has a strong chance of having it, too. In cleft hand, that chance is 50 percent.
- A cleft hand can also occur in isolation, or as part of a genetic syndrome.
- The condition affects between one in 10,000 and one in 90,000 babies.
- All affected children, except those with very mild cases, need one or more surgeries, usually starting in their first year of life.
- Surgery’s first goal is to improve hand function (the ability to grasp, pinch, and let go of objects); this requires the surgeon’s careful attention to the thumb.
- The second goal is to improve the hand’s appearance.
- Surgery usually is performed in the child’s first or second year of life.
- When planning surgery, the surgeon must reconstruct not just the bones of the hand, but also the soft tissues, such as ligaments and nerves.
How Children’s Hospital Boston approaches cleft hand
You can have peace of mind knowing that the skilled experts in our Orthopedic Center’s Hand and Orthopedic Upper Extremity Program have treated thousands of babies and children with cleft hand and many other hand problems. We provide expert diagnosis, treatment and care, and we benefit from our advanced clinical and scientific research.
Our Orthopedic Center—one of the first of its kind in the nation—is nationally known as a premiere center for orthopedic care of children and young adults with developmental, congenital, neuromuscular, sports related, traumatic and post-traumatic musculoskeletal problems.
|We offer orthopedic care north, south and west of Boston|
Boston Children’s physicians provide orthopedic care at Children’s locations in Lexington, Peabody, Weymouth and Waltham, as well as at our main campus in Boston.
|If you live far from the United States, Children’s can help|
As an international children’s orthopedics center, we treat young patients from the world over. Children’s International Center helps families residing outside the United States—facilitating the medical review of patient records; coordinating appointments; and assisting families with customs and immigration, transportation and lodging.
Cleft hand: Reviewed by Peter M. Waters, MD
© Children’s Hospital Boston, 2012