Common congenital malformations of the fingers are polydactyly and syndactyly. There are many different classifications of polydactyly and syndactyly. Before surgery, routine radiographs are needed to understand the bony condition of the hand. The timing of surgery for polydactyly and syndactyly is usually around one year of age, or earlier if the child is well nourished, but usually after half a year of age. Since children need general anesthesia for surgery, it is more likely that they will be too young to have an infusion. If the child is too young, it is more difficult to perform surgical infusions and the risk of anesthesia is relatively high. On the other hand, the earlier the surgery is performed the better the relative recovery is. This is especially true for deformities that interfere with normal finger development. The surgical approach varies depending on the type of polydactyly and syndactyly. Some patients may require repeat or multiple surgeries after a single operation as the child grows and develops.