Malformations

MALFORMATIONS AND CAUSES

Malformations of the hand are rare, but generate a great concern among parents who want a perfect projection on the future of their sons. By performing various surgical techniques, the surgeon's primary objective is to improve hand function and, in turn, improve aesthetics.

Some general concepts which, in turn, respond to questions generated by the parents are:
 

What is a malformation?

A malformation is a deformity of an organ or body part, which occurs during the first 8 weeks of pregnancy (embryo stage). At this time, your baby is the size of a bean.

Why is there a malformation in the hand? When does the intake of substances (teratogens) cause malformation?

• In most cases the cause is unknown.
   
• Currently very few defects are associated with teratogens. Transverse deficiencies have been associated with the use of vasoconstrictors, such as cocaine and prostaglandins. In the 60's, thalidomide , which was used for vomiting, caused an outbreak of birth defects
   

Can defects be inherited or inheritable?

Some birth defects are hereditary. This means that they have been "transmitted" by the parents and can be "transmitted" to their offspring. In that case, the patient should be referred to a geneticist. Examples are the central deficiency or cleft hand, polydactyly of the little finger, some syndactylies, some radial clubhands (radial deficiency), etc.

 

Should I worry about the overall health of my baby? Are they associated with malformations in other organs? Do I need other tests?

• Most malformations are not associated with problems in other organs, and do not require evaluation by the pediatrician or further studies.
   
• The radial clubhand and hypoplasia of the thumb, in 30% of cases, may be associated with problems in other organs, as a syndrome (set of associated malformations). Therefore, it is mandatory to implement a set of studies to rule out these problems by a geneticist or a pediatrician.
   
• Other malformations that may be associated with syndromes are: polydactyly of the little finger in the white race, brachydactyly, etc.
   

Who is the best health professional to treat my baby with a malformation of the hand?

The pediatric hand surgeon has proper knowledge about the possible inheritance of the malformation, and its association with syndromes. Therefore, he will advise on the need for genetic counseling, a comprehensive evaluation by a pediatrician, or other tests.

Moreover, the surgeon will know the best treatment and the best time for surgery, if needed, in order to obtain a better functionality of the upper extremity.