Innovations in Care for Congenital Hand Differences

Innovations in congenital hand differences (CHD) are discussed in the context of five landmark publications that have guided that innovation. The five landmark publications include (1) the Swanson classification, (2) pollicization, (3) prosthetics, (4) digital lengthening, and (5) toe-to-hand transfer. The Swanson classification system provides a universal framework for understanding the range of CHD and helps guide treatment planning and management. Pollicization, in which a finger (usually the index) is relocated to function as a thumb, has been a significant innovation in the treatment of thumb hypoplasia. The field of prosthetics for CHD has seen numerous innovations such as 3D Printing and myoelectric prosthetics and they have the potential to significantly improve quality of life of children with CHD. Ideas and innovations in surgical techniques such as toe-to-hand transfer and digital lengthening have expanded treatment options for congenital shortening of the digits, leading not only to improved function but also appearance of the hand.