Pediatric hand differences encompass a range of congenital or acquired conditions that affect the form and function of a child's hands. Because a child's hand is still growing, timing and technique matter: early diagnosis and a well-planned intervention can optimize hand function and shape as the child develops.
Treating children is different from treating adults. Pediatric plastic surgeons complete one to two additional years of fellowship training beyond their plastic surgery residency. Dr. Panossian trained at two of the most respected institutions in the world for pediatric plastic surgery — the Hospital for Sick Children in Toronto and Children's Hospital Boston (Harvard) — and draws on subspecialty training in microsurgery to reconstruct even the most complex hand differences.
Whether your child has a straightforward or a complex reconstructive problem, care is individualized to your child's anatomy, age, and goals — with the same philosophy applied to every case: understand the anatomy completely, plan meticulously, and never settle for "good enough."
From common webbing of the fingers to complex differences of the thumb and forearm, Dr. Panossian evaluates and reconstructs the full range of pediatric hand conditions. Select a condition to learn more.
Webbing or fusion of two or more fingers, the most common congenital hand difference. Surgery separates the joined digits and resurfaces the skin to restore independent finger movement.
An extra finger or portion of a finger. Treatment removes the extra digit and, when the thumb is involved, reconstructs the ligaments, tendons, and joint to preserve a stable, functional thumb.
An underdeveloped or absent radius that curves the hand toward the thumb side. Care may include stretching, splinting, and staged surgery to improve wrist position and function.
An underdeveloped or absent thumb. Depending on severity, reconstruction rebuilds a stable, opposable thumb or repositions the index finger (pollicization) to serve as one.
A rare overgrowth in which one or more fingers are enlarged. Treatment is individualized to reduce size, balance growth, and preserve hand function and appearance.
Short, webbed, or missing fingers, often with a small hand. Reconstruction is tailored to the child's anatomy and may include digit separation or transfer procedures to improve grasp.
A fixed bend of a finger at the middle joint, most often the small finger. Management ranges from splinting and therapy to surgical release when the bend limits function.
A sideways curvature of a finger, usually the small finger, from an abnormally shaped bone. Correction, when indicated, straightens the digit to improve alignment.
A central hand difference in which one or more central fingers are absent, creating a cleft. Reconstruction closes the cleft, deepens web spaces, and optimizes pinch and grasp.
A thumb that catches, locks, or clicks when bent, from a mismatch between a tendon and its sheath. A small release procedure restores smooth, painless motion.
Tight tissue bands that form around a finger or limb before birth, which can cause indentation, swelling, or incomplete development. Surgery releases the band and reconstructs the tissue.
A benign, fluid-filled lump, most often at the wrist, that can cause discomfort or limit motion. Treatment ranges from observation to removal when it is painful or limiting.
Dr. Panossian also cares for a range of general pediatric conditions, applying the same reconstructive precision.
Dr. Panossian treats the full range of congenital and acquired hand differences in children, including syndactyly (webbed fingers), polydactyly (extra digits), radial club hand, thumb hypoplasia, macrodactyly, symbrachydactyly, camptodactyly, clinodactyly, ectrodactyly (cleft hand), trigger thumb, constriction ring syndrome, and ganglion cysts.
Timing depends on the specific condition and your child's development. Because a child's hand is still growing, many congenital hand procedures are planned for early childhood so the hand can develop and function well as the child grows. Dr. Panossian recommends the right timing for your child's condition at consultation.
Congenital and functional hand differences are generally treated as reconstructive rather than cosmetic, so they are often covered by insurance. Coverage varies by plan, so it is best to verify benefits with your insurer. Our office can help you understand what to expect.
The goal of surgery is to maximize the hand's function and appearance as your child grows. Outcomes depend on the specific condition and its severity, and Dr. Panossian discusses realistic, individualized expectations with every family at consultation.
Some hand differences affect appearance only, while others can limit grip, pinch, or normal growth of the fingers. An evaluation determines whether surgery would help and, if so, the best timing. The first step is a consultation with a surgeon experienced in children's hands.
Dr. Andre Panossian is a board-certified plastic surgeon with fellowship training in pediatric plastic surgery at the Hospital for Sick Children in Toronto and in microsurgery. His combined expertise in pediatric and hand surgery makes him well suited to treat both simple and complex congenital hand differences.
If your child has a hand difference, Dr. Panossian can help you understand the options and the right timing for care. Schedule a consultation — in person or virtual — to take the first step.
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