Split hand deformity is characterized by the splitting of the fingers and palm into two parts in the middle of the hand on the ulnar and radial sides, also known as split hand deformity, and many are associated with missing fingers and missing finger deformity. Split hand is mostly bilateral, but also unilateral, and has a genetic predisposition. Typical split hand: a central absence, while the marginal fingers are still normal. The manifestations are: metacarpal and phalangeal dysplasia; metacarpal dysplasia with defective fingers; both metacarpals and fingers are defective. Due to the varying degrees of defects and dysplasia, it can manifest as different types of split hands with single fingers to 5 fingers. In the 2-finger split hand, only 2 fingers on the ulnar or radial margin are present, and the hand resembles a lobster pincer due to the absence of the central fingers, commonly known as lobster pincer hand. Atypical split hand: for central hypoplasia and marginal tissue degeneration. Polydactyly: The hand is split into two parts, ulnar and radial, with varying degrees of dysplasia of the central longitudinal fingers and metacarpals, but also with polydactyly, and also with compound thumb deformity. Syndactyly: It has the characteristics of typical split hand, with different degrees of dysplasia or defects in the finger bones and metacarpals of the central longitudinal cleft. The combined syndactyly can be found in the thumb, index finger, or between the ring and little fingers. Sometimes there is also fusion of the carpal bones and fusion of the ulnar radius. Treatment: Surgery can be performed at the age of half a year to repair the cleft, remove the abnormally deformed bones, and reconstruct the finger web to improve appearance and function. Any combined other deformities are treated accordingly. The most common complication after surgery is finger rotation, which simply means that the fingers will cross when they are flexed, and secondly, if not done properly, there is also a tendency to develop web deformities, where the webs are too wide or narrow, too high or too low. Therefore, the appearance and function can be affected if not done properly. The child, male, 3 years and 5 months old, had a right cleft hand with missing middle finger. X-rays showed the hypoplastic middle finger metacarpal between the cleft and the redundant bone at the root of the index finger. The redundant bone was surgically removed, the hypoplastic middle finger metacarpal was removed, the cleft was repaired, and the finger web was shaped. Immediately after surgery, the incision was concealed in the transverse palm line, and in plastic hand surgery, the incision must be considered aesthetically pleasing in addition to the functional repair. One month after the surgery, the webbing was natural and the scar of the incision was not obvious. After the surgery, the fingers are in flexed position, no crossed finger deformity is seen, and the function is very good. The child’s ring finger nail was caught in a naughty way.