Operative Treatment of Congenital Split Hand

Genrietta S. Godunova


Summary in English reprinted from Orthopedics, Traumatology and the Application of Prostheses, No. 6, 1973, with the kind permission of the author and publisher.

The author observed 27 patients with split hand (24 children and 3 parents). Transmission of the deformity was hereditary in 4 families in 10 patients. The form of split hand was typical in 12 patients on 20 hands (Figs. 1-a through 1-e ), and atypical in 15 patients on 23 hands (Figs. 1-g through 1-k ). Eighteen patients (5 with bilateral deformity), aged 1 1/2 up to 13 years, underwent 23 operations. In correction of splitting, the interdigital fold between the rapproched fingers was made from local tissues, zigzag incisions were used for approach to the metacarpal and carpal bones. In the majority of cases the intervention was on the hand skeleton: cuneiform resection of carpal bones, marginal resection of proximal ends of metacarpal bones with their subsequent approximation with the aid of thick silk thread, etc. (Fig. 2 ). Long-term results, with follow-up to 10 years after intervention, revealed that by means of operative treatment an improvement both of the cosmetic state and bone function may be achieved. The best outcomes were observed after correction of splitting in children of earlier age (Fig. 3 ).

Vitebskiy Prospect Leningrad, USSR.