In the clinical work of hand surgery, we often receive children with congenital deformities of the hand, parents often have a lot of questions, such as what causes these deformities, polydactyly and eating crabs in pregnancy has no relationship, congenital deformities when the correction is more appropriate, why can not do the operation after a cold, after the correction of the effect of how to, etc., with these questions, let’s go together to understand the congenital deformities of the hand. 1.What are the causes of congenital deformities? Hand and upper limb deformity is part of the human congenital malformation, and may be combined with multiple organs or systems of the body malformation, seriously affecting the healthy growth of human beings. Congenital malformations account for 1-2% of newborns. The proportion of upper limbs is 10%, and the incidence of congenital limb malformations is only slightly lower than that of congenital cardiac malformations. Common malformations of the hand are polydactyly, syndactyly, giant fingers, short fingers, fascicular contracture, stenosing tenosynovitis, etc. Many parents of children with congenital malformations ask, “Why do malformations occur? What is the etiology of the deformity?”. What is the cause of the deformity?”. In fact, the etiology of congenital malformations is very complex, can be broadly categorized into hereditary and environmental factors, genetic factors account for about 5% of the hand deformities, mainly including chromosomal abnormalities, gene mutations, consanguineous marriage. Environmental factors, i.e., malformations occurring during the embryonic period under the influence of external factors, including drug factors (e.g., anticancer drugs, contraceptives), disease factors (e.g., the mother suffers from rubella during pregnancy), nutritional factors (e.g., lack of vitamins C and A), radiological factors, endocrine factors, etc. In short, its etiology is multifactorial. In short, its etiology is multifactorial and unclear. Most of the upper limb deformities occur in 4~8 weeks (8 weeks the whole upper limb is fully formed) so it is especially necessary to pay attention to prevention in early pregnancy. As for eating crabs in pregnancy caused by polydactyly, there is no scientific reason, is a kind of superstition. 2. What should parents do if their child has a congenital deformity of the hand? When a child is born with a congenital deformity of the hand, the parents first need to take the child to the hospital for some necessary examinations to rule out whether the child is combined with malformations of the heart and other organs. In the case of a simple congenital deformity of the hand, parents need to overcome their own low self-esteem and encourage their child to use the hand with the disability. Communicate with the surgeon about the loss of function and the benefits of surgery. After the surgery, we should cooperate with the child to carry out functional rehabilitation training. 3.How to grasp the timing of surgery for congenital deformities of the hand? Due to the lack of awareness of hand and upper limb congenital anomalies among a considerable number of parents, they consult the doctor late and miss the best treatment period. Usually for hand or upper limb congenital malformations, early treatment, early correction of bone and joint deformities, to prevent the development of deformity, to restore the normal function of the limb, to ensure the normal growth and development of the child is the principle of treatment of deformity. Deformity correction in infancy is conducive to the development and reconstruction of the anatomical structure and function of the repaired hand, as well as the psychological development of the affected children. However, for deformities that do not hinder development, such as certain types of polydactyly, treatment can be delayed until school age. Surgeries involving bone and joint orthopedics, especially those affecting bone development, are best done after bone development has basically stopped. For tendon surgery, it is usually better to wait until the child is able to initiate functional training, at the earliest after the age of 5 years. Surgical treatment of hand and upper limb deformities should be accompanied by the planned and staged use of braces and casts, which can help to further correct the deformity. Children in the growth and development period, plasticity, most of the hand deformity if early diagnosis, and get a systematic, reasonable treatment, to their conscious guidance and training, can let the child get a pair of normal hands. However, if the diagnosis and treatment are delayed, the deformity will become more and more serious, not only the difficulty of orthopedic increase, and even leave a lifelong disability, but also will cause serious psychological harm to the child. 4.What kind of anesthesia is used and is there any risk? For shorter surgery, intravenous basic anesthesia is usually adopted, and for longer surgery, intubation general anesthesia is usually adopted. No matter what type of anesthesia is used, it is safe and will not affect the child. However, before the surgery, we must ensure that the child has no recent cold, pneumonia and other respiratory diseases, in order to prevent respiratory obstruction. 5.Will the surgery affect the growth and development of the child’s limbs? The purpose of the surgery is to correct the appearance of the limb deformity, so that the limb grows and develops in a normal direction. However, for some special deformities, there is still a certain degree of deformity left on the appearance with its growth and development, and some deformities need multiple surgeries until their adult bone development stops before the end. 6. What are the surgical results of orthopedics? The main purpose of surgical treatment is to improve the function, taking into account the improvement of the form. For some common congenital deformities of the hand, such as polydactyly, syndactyly, thumb hypoplasia, macroglossia, etc., as long as reasonable treatment and follow-up, usually can achieve more satisfactory results and restore good hand function. For some complex and serious deformities, as long as the reasonable treatment, the appearance and function will also have a great degree of improvement. 7.Where should patients with congenital deformities of the hand go for consultation? Patients with congenital deformities of the hand should go to a regular hospital for diagnosis and treatment by a hand surgeon.