CLEFT HAND ANOMALY: A REVIEW OF FUNCTIONAL & AESTHETIC ASPECTS FROM PATIENTS & DOCTOR PERSPECTIVE

Abstract

Introduction: Hand help us to perform our work and express ourselves. Cleft Hand is a congenital hand deformity caused by a defect in the central part of the apical ectodermal ridge during embryological development, that is characterized by the absence of 1 or more central digits of the hand or foot. Classically, this results in a "V-shaped" cleft in the hand with a variable degree of deformity. Cleft hand is more of an aesthetic deformity rather than functional. We document our experience in 10 such cases from ages of 3 to 10 years who  underwent reconstruction under general anesthesia. 

Objective: The main goals of cleft hand surgery are to restore hand function and to improve the appearance of the hand.

Study design: Descriptive Case series study

Study duration & settings: Department of Plastic Surgery & Burns, Ayub Medical Complex, Abbottabad from September 2023 to October 2024.

Materials and methods: The total of 10 patients of cleft hand was enrolled in study period. The mean age of patents were 5.5 years. There were 6 male and 4 female patients. There were 2 patients with bilateral cleft hand. 6 patients underwent snow-littler procedure, 2 underwent osteotomy and 2 underwent removal of transverse bone. Splintage was done for 6 to 8 weeks and physiotherapy started. Function was assessed at 6 months.

Result: The operating time was 2 to 3 hours. No major post operative complications were noted. The parents’ satisfaction was excellent at 06 months. None of patient needed revision surgery for recurrence or first web space widening.

Conclusion: Our study concludes that cleft hand needs to be analyzed for the adequacy of first web space. The reconstruction is aimed at functional first web space and cleft closure for providing better aesthetic and functional results.