Split hand is a relatively rare congenital malformation of the hand and can be difficult to treat. It can occur unilaterally or bilaterally and is also known as “lobster hand” or “crab hand”. The typical split hand is characterized by hypoplasia of the middle part of the hand, most commonly the third row of the middle finger, which is hypoplastic or absent, showing a V-shape. The fingers next to the split hand often have a deformity such as syndactyly. When the thumb and index finger are completely parallel, the thumb may be hypoplastic. When both hands are included and bipedal schizotypy is present, it is most often an autosomal dominant pattern of inheritance. In most cases, the simple grasping function of the split hand is impeded by the second finger row, the index finger row, and the basic goal of treatment is to shift the index finger row to a position that does not interfere with the grasping function of the thumb. Currently, the indications and timing of treatment for split-handedness are controversial. In cases with flexion contracture of the fingers, thumb and index finger juxtaposition, and index finger column interference with hand function, it is important to operate as early as possible. The first treatment is usually done around one year of age and the build-up is completed by about 5-6 years of age. There is no standard surgical procedure to treat split hands, due to the fact that split hands vary widely and the surgical plan is tailored to each patient’s situation. However, most patients have a better thumb, a better tiger and a better little finger, which provides a good basis and conditions for improved function. The surgical protocol is mostly an improvement on the snowlitter’s approach, which, in short, is to create a good tiger’s mouth, create an index finger row of appropriate length and function, reconstruct the metacarpal ligaments, and preserve as much as possible the residual internal retraction of the thumb. Parents of affected children should realize that no matter how much treatment is given, the result of split hands never achieves the morphology and function of normal fingers. By adolescence, changes such as angular deformity of the fingers can occur. Some children with schizophrenia have a satisfactory appearance after the first correction, but later have to be treated again. It is worth mentioning that the treatment of split feet and split hands should be carried out simultaneously, and the general principles are the same as for hands.