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Plastic and Reconstructive Surgery

Congenital Hand Differences

Overview | Conditions | Referrals


Congenital hand conditions are differences (anomalies) in the hand and arm that occur when a child is developing before birth. 

The anomaly may occur by itself or can be associated with problems with other body systems. The musculoskeletal (bones and muscles), cardiovascular (heart, arteries and veins), craniofacial (head and face) or neurological (brain, spinal cord and nerves) systems are most commonly involved. When a hand anomaly is part of a syndrome, a geneticist and/or other specialists may be involved with the child's care. Congenital hand anomalies may have genetic, environmental or unknown origin.

There are many different types of congenital hand conditions. Some of the more common anomalies include:

    • having more or fewer than five fingers
    • fingers that will not bend or will not straighten
    • fingers that are joined together
    • bones in the hand or arm that are too short or missing

Below you will see a list of some of the more common anomalies organized into their classification groups. 

To learn more about a specific condition and the treatment options - 










Failure of formation of parts:

Congenital Amputation: Amputation (loss) of arm

Radial Ray Anomaly: Absent or underdeveloped radius bone

Ulnar Ray Anomaly: Absent or underdeveloped ulna bone

Cleft Hand: Absence of central part of hand

Symbrachydactyly: U-shaped underdevelopment of hand with short fingers


Failure of differentiation of parts:

Syndactyly: Fingers are fused together

Camptodactyly: Abnormal bending of middle joint of finger

Clinodactyly: Bending of finger towards the side

Symphalangism: Stiffness of finger in any joint

Arthrogryposis: Abnormal shortening (contracture) of joint tissues


Polydactyly: Extra finger(s) is (are) present


Hypoplastic Thumb: Under development or absence of thumb


Macrodactyly: Enlargement of finger(s)

Congenital Constriction Band Syndrome:

Constriction Band Syndrome: Ring-like tightening of skin often causing amputations

Generalized Skeletal Deformities:

Madelung's Deformity




Referrals to the Congenital Hand Clinic can be made from Community Paediatricians, Family Physicians and Plastic Surgeons.

Referring professionals accepted:

Family physicians
Other specialists

Patient group parameters:

Some cases may be more suitable for our satellite clinics.

Requirements pre-visit:


If x-rays have been done please have them accompany patients to the clinic.

Detailed description of polydactyly or syndactyly required

Initial Visit:

Within two to six months of receipt of referral

Age limit:

18 years


  • All patients require a referral to visit our clinic.
  • If you are a health-care professional, log in to eCHN to submit your referral. From your eCHN account, you will be seamlessly connected to SickKids e-referral platform, EpicCare Link.
  • Learn more about our referral process.
  • For urgent referrals only (same day referrals), contact eCHN’s Helpdesk directly 416-813-7998 or 1-877-252-9900, or by email at helpdesk@echn.ca. On weekends and after 6 p.m. on weekdays, please contact the Fellow on call via SickKids Locating at 416-813-1500.

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