Congenital hand malformations are a common disease, with an incidence of about 1 per 1,000 newborns. It can also be accompanied by cardiovascular malformations, hematopoietic disorders, digestive malformations, facial malformations, craniocerebral malformations, urogenital malformations and lower limb malformations. The causes of congenital hand disorders are complex, with genetic factors, but also with the external environment at the time of embryo, including biological, nutritional, drug, radiation, endocrine, trauma and so on. The most common congenital hand disorders include polydactyly and syndactyly. (i) Polydactyly, commonly known as “six fingers”, is more common in males than in females, and is more common in the right hand than in the left hand. Most can be diagnosed at the time of delivery. For simple polydactyly, especially ulnar polydactyly, it is better to operate 3-6 months after birth; for complex polydactyly with severe deformity and tissue loss, polydactyly should be excised after 1 year of age and surgically reconstructed, and should be reviewed regularly until the developmental cessation. The early efficacy of polydactyly is relatively satisfactory, but with the development of the child, a small number of secondary deformities may occur, and long-term follow-up is required until developmental cessation. (ii) Syndactyly, a congenital pathology in which some or all of the tissue components of two or more fingers are congenitally connected, is more common in boys. Congenital syndactyly usually requires surgery. The timing of surgery depends on the form and degree of syndactyly, the general health status of the child, the safety of anesthesia, and parental request. For simple incomplete syndactyly of 2 or 3 fingers, surgery can be performed within 6 months, while surgery for complex syndactyly should be performed after 3-4 years of age, and surgery for syndactyly of multiple fingers should be staged. Children’s skeletal system is in the period of growth and development, plasticity is strong, most of the hand deformity if early diagnosis, and get systematic and reasonable treatment, 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, which will not only increase the difficulty of orthopedics, even leave lifelong disability, but also cause serious psychological harm to the child.