we present a case of a six-year-old male child with cleft hand deformity involving
the dominant right hand. it was a rare case of atypical cleft hand with no missing
tissue but cleft extending to metacarpal level and associated hypoplasia of thumb
and index finger. as per manske′s classification of cleft hand our patient belongs
to the class iii variety. there was associated malposition of the index finger with
absence of first web space and syndactly of thumb and index finger at the metacarpal
level. a modified snow-littler procedure was planned. the surgical plan involved closure
of cleft, release of thumb and index finger syndactly and reconstruction of the first
web space. the functional outcome was good considering hypoplasia of the index finger
and thumb. depending upon the function of the thumb tendon transfers can be planned
to augment thumb function at a later date along with correction of rotational deformities
of the index and middle finger.
KEY WORDS
Central hand deficit - cleft hand - split hand
