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Your Guide To Congenital Hand Deformities

Your Guide To Congenital Hand Deformities

Congenital hand deformities are a group of conditions that affect the formation and function of a child’s hands during fetal development. These conditions may range from webbed fingers to missing fingers, and they can significantly impact a child’s quality of life. 

In this article, we will discuss some of the most common congenital hand deformities, their causes and the available treatments in Singapore. We will also highlight the risk factors that may increase the likelihood of your child developing malformed fingers


In the early stages of pregnancy, a baby’s hands initially form as a paddle and then develop into separate fingers around the sixth to eighth week. However, in cases of syndactyly, two or more fingers do not properly separate during this process, resulting in fused or webbed fingers. 

It can occur in both hands (bilateral) or just one hand (unilateral). Its severity can vary widely, ranging from simple skin webbing to more complex cases involving bones, joints, and nerves. The condition is estimated to affect once in every 2,000 to 2,500 births.


Treatment for this condition includes surgery, typically performed when the child is one to two years old. Surgeons will evenly split the skin between the fingers and may use a skin graft or substitute to cover the separated fingers and minimise scarring. If there are multiple finger deformities, surgeons will perform multiple surgeries to prevent complications.


Polydactyly is when a baby is born with one or more extra fingers, which can manifest in various forms, ranging from small skin tags to fully formed digits with bones, joints, and nails. The extra fingers can be located on the small finger side, on the thumb side (also called thumb duplication), or in the middle of the hand. The prevalence is one in every 500 births.


The removal method depends on the size and location of your child’s extra finger. If a small skin bridge connects the extra finger to the hand, the skin bridge can be clipped or tied. It will naturally fall off afterward. If your child’s extra finger is more developed, though, they may need surgery.


Characterised by a range of finger abnormalities, which may include shortened fingers, underdeveloped fingers, or even complete absence of fingers, this medical condition typically affects only one hand. It is estimated that the prevalence is one in every 32,000 births.

The exact cause of this condition is not known, but what we know is that it has nothing to do with what the parents did or did not do during pregnancy. 


Treating this condition requires a multi-disciplinary approach, including consultation with hand surgeons, occupational therapists, and other specialists to determine the most appropriate course of action. Surgeries, prosthetics and assistive devices may be prescribed to a child with this condition. 

Club hand

Club hand is a congenital condition that affects your child’s forearm and hand, resulting in their forearm turning inward. Club hand limits their wrist movement, either on the radial (thumb) or ulnar (pinky finger) side. Radial club hand causes a short or absent thumb, and the forearm appears to be curved like a J-shaped club. 

Ulnar club hand involves shortness or absence of the ulnar bone, causing the wrist to bend at an angle. Both types of club hand may be associated with other abnormalities in the blood, heart, intestines, or spine. 


Treatment options vary depending on your child’s functional abilities and needs. They may include limb manipulation, splinting, casting and surgery.

Cleft hand

A cleft hand is a congenital hand difference where some fingers or parts of fingers in the centre of the hand are missing, resulting in a V-shaped cleft. A typical cleft hand is characterised by a gap in the palm and the absence of the middle finger(s). It can occur on one hand (unilateral) or both (bilateral), and the hand size and arm bones are usually normal.


The available treatments for a cleft hand depend on the severity and functional needs of your child. They may include limb manipulation and stretching, splinting or casting, and/or surgery to reconstruct the hand and improve its function.

The Risk Factors Of Developing Hand Deformities


Genetics plays a significant role in the development of hand deformities in Singapore. If your family has a history of hand deformities, the risk of you developing it is higher. 

Environmental Factors 

Maternal use of tobacco, alcohol, and illicit drugs during pregnancy has been linked to an increased risk of hand deformities in newborns.


Some medications have been associated with an increased risk of hand deformities during pregnancy. 

Looking for a Hand Deformity Specialist in Singapore?

If you are a parent, receiving news that your baby has malformed fingers can be distressing. With the right management and treatment, though, your child can still enjoy a good quality of life. 

At Spire Orthopaedic, we are ready to help you every step of the way. From diagnosis to treatment, we offer personalised and evidence-based care to help your little ones achieve the best outcomes.  Contact us today!

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