Tactics of surgical treatment of congenital pathology of the hand in children

Results of surgical treatment for congenital hand pathology in children were presented. There were 355 patients with the following pathology: polydactyly (136 patients; syndactyly (125 patients); amniotic disease (26 patients); clinidactyly (25 patients); and other rear forms of congenital hand pathology (23 patients). Five hundred ninety two operations were performed. In symmetric thumb doubling Bilaut-Cloquet operation performed in 2—3 years old children was shown to be effective. In asymmetric thumb doubling it was necessary to remove the additional thumb and simultaneously to correct the axis of the main thumb. That operation should be performed in children of 1—2 years old. Separation of fingers using triangular flaps and combined skin plasty was carried out in children of 5-6 years of age. In children under 5-6 years the separation of fingers should be performed when finger axis has been deformed during the growth. Indication to axis correction was its deformity by 15—20°. Excision of circular amniotic strangulation should be performed using one step advancement of triangular flaps. In severe hand malformations which required multistep surgical interventions the treatment should be started as early as possible.