Our Summary

This research paper discusses a rare birth defect called an ulnar cleft hand, where there is a split between the little finger and the ring finger. Sometimes, this condition also means the baby is born without a finger. The treatment focuses on closing the split, increasing the size of the undersized little finger, and preserving the function of the hand. The paper shares the experiences of two patients with this condition, neither of whom were missing fingers. Both patients had surgery to close the split in their hands. One also had a procedure to lengthen their little finger using an external device, while the other had a procedure to move their finger to a different location. Both treatments were successful, resulting in a nearly normal finger length and a hand that looks and works reasonably well.

FAQs

  1. What is an ulnar cleft hand?
  2. What are the goals of treatment for ulnar cleft hand?
  3. What methods were used to treat the patients with ulnar cleft hand in the reported cases?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hand surgery is to follow post-operative instructions carefully to ensure proper healing and optimal outcomes. This may include keeping the hand elevated, performing prescribed exercises, attending follow-up appointments, and avoiding activities that could put strain on the hand during the recovery period. It is important to communicate any concerns or changes in symptoms to the doctor promptly.

Suitable For

Patients with ulnar cleft hand deformities, ectrodactyly, hypoplasia, split-hand deformities, and other congenital hand deformities are typically recommended for hand surgery. The goals of surgery for these patients are to improve function, aesthetics, and overall quality of life. Patients with ulnar cleft hand deformities may undergo procedures such as cleft closure, finger lengthening, finger translocation, and other reconstructive surgeries to achieve optimal outcomes.

Timeline

Before hand surgery:

  • Patient may have been diagnosed with ulnar cleft hand, a rare congenital deformity presenting with a cleft between the ring and little finger.
  • Patient may have experienced functional limitations and aesthetic concerns due to the deformity.
  • Treatment goals may have been discussed with the patient, including cleft closure, increasing the length of the hypoplastic little finger, and preserving function.

After hand surgery:

  • Patient undergoes cleft closure surgery to address the deformity.
  • Depending on the specific case, patient may have undergone additional procedures such as lengthening of the fifth metacarpal with an external fixator or finger translocation.
  • Patient achieves a near normal length of the little finger and a reasonable functional and aesthetic outcome.
  • Patient may undergo post-operative rehabilitation and follow-up appointments to monitor healing and function.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with hand surgery for an ulnar cleft hand?
  2. What is the expected recovery time and rehabilitation process after the surgery?
  3. Will I need physical therapy or occupational therapy after the surgery?
  4. What type of anesthesia will be used during the surgery?
  5. What are the long-term outcomes and prognosis for someone with an ulnar cleft hand who undergoes surgery?
  6. Are there any alternative treatment options or non-surgical interventions that could be considered?
  7. How experienced are you in performing surgery for ulnar cleft hand deformities?
  8. Will there be any scarring or visible signs of the surgery after it has healed?
  9. How soon after the surgery can I expect to regain full use of my hand?
  10. What should I do to prepare for the surgery and what can I expect during the recovery process?

Reference

Authors: Nakagawa K, Takayama S, Hidaka N, Nakamura H. Journal: J Hand Surg Asian Pac Vol. 2022 Feb;27(1):178-182. doi: 10.1142/S2424835522720043. Epub 2022 Feb 17. PMID: 35172701