Hand disorders in children present a unique situation compared to hand disorders in adults. Bony problems in children are more challenging because an X ray does not reveal complete information as it does in grown ups. While treating children, surgeon has to take in account the future growth of the child and hand in particular which again is not a factor in grown ups. Paediatric hand problems can be broadly divided in 2 categories - Congenital [since birth] and Acquired. Congenital disorders can be syndactyly [fused fingers], polydactyly [extra fingers],
trigger thumb or fingers and many more. Acquired problems are usually along similar lines as in adults -
fractures of bones,
injury to tendons, nerves etc. Syndactyly is amongst a relatively common congenital problems in which two or more fingers are fused together since birth. The nature of problem can be simple as in fusion of only skin and soft tissue or more complex when bones underneath are fused as well. In the demonstrated case 3rd to 5th fingers were fused in 10 years old boy in left hand. Connection between 3rd and 4th finger was more worrisome as bones were fused in them. Hence in was decided to tackle that first. The advisable age for surgery in such cases is between 2-4 years however this child presented late. The middle and ring fingers were successfully separated ensuring good function and cosmesis. This surgery usually needs skin grafts, that means to close the wounds we need to borrow skin from elsewhere in body. This can be done without any long termside effects or unsightlyness as happened with this child. For more information
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Dr Nilesh Darawade -
Best Hand Surgeon Pune. 
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