Surgical management of atypical cleft hand: Rare congenital orthopedic disorder.

INTRODUCTION AND IMPORTANCE

Cleft hand is a rare congenital deformity which may impair the aesthetic appearance and psychosocial of a child. The operative technique of cleft hand is rarely reported. We aimed to describe the surgical management of cleft hand.

PRESENTATION OF CASE

A 5-year-old girl was presented to our department with the right hands split in half, forming a V-shaped cleft. The child also had finger and feet deformities. We performed a complex surgical procedure, consisting of first web correction, cleft closure, close wedge osteotomy at carpometacarpal joint, internal fixation with k-wire for base metacarpal, and ablation for accessory finger at radial side of index finger. The surgery was uneventful and the parents were satisfied with the result.

CLINICAL DISCUSSION

Several surgical approaches had been proposed to manage cleft hand. A surgical approach of first web correction, cleft closure, close wedge osteotomy at carpometacarpal joint, internal fixation with k-wire for base metacarpal, and ablation of accessory finger was a reasonable approach to improve hand cosmetic and function.

THE CONCLUSION

Surgical treatment of cleft hand is important to improve hand cosmetic and function. Each patient may present with different deformities and the surgical approach must be individualized.