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Malformations of the hand are rare, but generate a great concern among parents who want a perfect projection on the future of their sons. By performing various surgical techniques, the surgeon's primary objective is to improve hand function and, in turn, improve aesthetics.
Some general concepts which, in turn, respond to questions generated by the parents are:
 

What is a malformation?

A malformation is a deformity of an organ or body part, which occurs during the first 8 weeks of pregnancy (embryo stage). At this time, your baby is the size of a bean.

Why is there a malformation in the hand? When does the intake of substances (teratogens) cause malformation?

  • In most cases the cause is unknown.
     
  • Currently very few defects are associated with teratogens. Transverse deficiencies have been associated with the use of vasoconstrictors, such as cocaine and prostaglandins. In the 60's, thalidomide , which was used for vomiting, caused an outbreak of birth defects
     

Can defects be inherited or inheritable?

Some birth defects are hereditary. This means that they have been "transmitted" by the parents and can be "transmitted" to their offspring. In that case, the patient should be referred to a geneticist. Examples are the central deficiency or cleft hand, polydactyly of the little finger, some syndactylies, some radial clubhands (radial deficiency), etc.

 

Should I worry about the overall health of my baby? Are they associated with malformations in other organs? Do I need other tests?

  • Most malformations are not associated with problems in other organs, and do not require evaluation by the pediatrician or further studies.
     
  • The radial clubhand and hypoplasia of the thumb, in 30% of cases, may be associated with problems in other organs, as a syndrome (set of associated malformations). Therefore, it is mandatory to implement a set of studies to rule out these problems by a geneticist or a pediatrician.
     
  • Other malformations that may be associated with syndromes are: polydactyly of the little finger in the white race, brachydactyly, etc.
     

Who is the best health professional to treat my baby with a malformation of the hand?

The pediatric hand surgeon has proper knowledge about the possible inheritance of the malformation, and its association with syndromes. Therefore, he will advise on the need for genetic counseling, a comprehensive evaluation by a pediatrician, or other tests.

Moreover, the surgeon will know the best treatment and the best time for surgery, if needed, in order to obtain a better functionality of the upper extremity.
 

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Diagnosis and Treatment of Shoulder Dysplasia
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Clinical experience of Dr Soldado
Malformations
Short or absent thumb: thumb hypoplasia
Deviated wrist: radial and ulnar clubhand
Short fingers: Brachydactyly, symbrachydactyly, amniotic band syndrome
Less fingers: cleft hand and ulnar clubhand
Extra fingers or thumb: Polydactyly
Glued fingers or syndactyly
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Definition, overview and assessment of cerebral palsy
Upper extremity problems in children with spastic hemiparesis
Nonsurgical treatment of spastic hemiparesis
The upper extremity in cerebral palsy with spastic tetraparesis
Surgical treatment of spastic hemiparesis
Microsurgery
Pediatric vascular microsurgery: overview
Bone loss reconstruction I: Vascularized fibula transfer
Bone loss reconstruction II: Periosteum transfer of vascularized fibula
Bone recalcitrant nonunion or pseudoarthrosis
Bone revascularization (osteonecrosis, aseptic necrosis)
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Reimplantation and revascularization
Functional muscle transfer (vascularized and innervated)
Skin loss coverage
Fractures/Injuries
Overview of fractures
Typical bone fractures in children
Treatment of fractures in children: overview
Classification and treatment of physeal fractures
Fractures of the shoulder girdle, shoulder and arm of the child
Elbow fractures of the child
Fractures of the forearm and wrist of the child
Hand fractures in children
Upper extremity injuries of the child
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