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.