Name of the Procedure:

Repair Cleft Hand (Cleft Hand Surgery, Split Hand Malformation Reconstruction)

Summary

Repair cleft hand is a surgical procedure to correct a congenital deformity characterized by missing or fused fingers, creating a cleft or split appearance in the hand. The surgery aims to create a more functional and aesthetically pleasing hand.

Purpose

Cleft hand repair addresses congenital hand deformities that hinder hand function and appearance. The primary goals are to improve hand functionality, enhance grip ability, and achieve a more normal hand appearance to improve the patient's quality of life.

Indications

• Congenital absence of central fingers.
• A widened gap between fingers.
• Reduced grip strength or dexterity.
• Functional impairment in daily activities.
• Cosmetic concerns affecting self-esteem or quality of life.

Preparation

• Preoperative fasting (typically 6-8 hours before surgery).
• Discontinue certain medications as advised by the surgeon.
• Routine blood tests and imaging studies (X-rays or MRI) to assess the extent of the deformity.
• Pre-surgical consultation for anesthesia evaluation and to discuss the surgical plan.

Procedure Description

1. The patient is administered general anesthesia.
2. An incision is made along the cleft of the hand.
3. The surgeon restructures the bones, tendons, and ligaments to form proper digit alignment.
4. Grafting may be used to recreate missing tissue or bone.
5. The cleft is closed using sutures to create a more typical hand shape.
6. A cast or splint is applied to immobilize the hand as it heals.

Duration

The procedure typically takes 2-4 hours, depending on the complexity of the deformity.

Setting

The surgery is performed in a hospital or specialized surgical center equipped to handle pediatric and orthopedic surgeries.

Personnel

• Orthopedic surgeon or plastic surgeon specializing in hand surgery.
• Anesthesiologist or nurse anesthetist.
• Surgical nurses and assistants.

Risks and Complications

• Infection or bleeding.
• Adverse reaction to anesthesia.
• Nerve injury leading to numbness or loss of function.
• Poor wound healing or scarring.
• Residual deformity requiring further surgery.

Benefits

• Improved hand function and strength.
• Enhanced ability to perform daily activities.
• Better cosmetic appearance of the hand.
• Increased self-esteem and psychosocial well-being. Benefits may be noticeable within a few weeks to months post-surgery, with full benefits typically realized once healing is complete.

Recovery

• Post-surgery immobilization in a cast or splint for several weeks.
• Pain management with prescribed medications.
• Physical therapy to enhance strength and flexibility.
• Follow-up appointments for wound checks and possible suture removal.
• Full recovery may take several months, with some limitations to hand use during this period.

Alternatives

• Non-surgical management, such as physical therapy and adaptive devices.
• Less extensive surgery, including amputation of non-functional digits.
• Pros and cons include potential for less optimal functional outcome but fewer surgical risks.

Patient Experience

• During the procedure, patients are under general anesthesia and won’t feel pain.
• Postoperatively, there may be discomfort and pain managed by medications.
• Emotional and psychological support may be beneficial as patients adapt to changes in hand appearance and function.