A GP guide to congenital hand and foot conditions

Knowing how to manage and when to refer these cases will ensure the best developmental and functional outcomes for the child

Need to know:

  • Most elective surgery for congenital hand and foot deformities is performed after six months of age, with the majority done after 12 months.
  • The decision may be made to correct foot issues prior to walking as the child is easier to manage.
  • Many hand differences are best corrected prior to the development of bimanual transferring activities.
  • Some congenital issues do not need surgery but may need splinting
  • Referral is warranted to assess the best treatment option and to follow the child’s function and development.
  • Parents need to be made aware of the natural history of the condition as well as the management options available for their child.

Mem Fox draws a sweeping generalisation in her widely read children’s book Ten little fingers and ten little toes that is not always reflected in the general paediatric population — particularly those attending paediatric plastic