Indications for Surgery and Functional Status of Patients with Congenital Hand Anomalies Persisting beyond Childhood

Background. Reconstruction for congenital hand anomalies, if indicated, is generally recommended during early childhood to optimize function before formal education starts and minimize the psychosocial impact. There have been limited reports on these conditions persisting beyond the recommended age for surgery.Objective. The research aimed to explore the common reasons why patients consult for late surgery and determine the baseline function of the patients prior to reconstructive surgery using the Filipino Disability of Arm Shoulder and Hand (Fil-DASH).Methods. An observational, chart review of cases from 2013-2021 was done. The reasons and indications wereextracted from the history and Fil-DASH scores were recorded with available data. The results were presented using summary statistics and tabulation of qualitative data.Results. Twenty-five hands in 20 patients underwent reconstruction of congenital anomalies persisting beyondchildhood. The most common indication for surgery was concerns regarding work opportunities. Hope for a better function, cosmesis, social pressure and hygiene were the other reasons mentioned. Most of the patients did not complain of significant problems in doing activities of daily living. This was supported by their Fil-DASH scores and employment status prior to surgery.Conclusion. In this population, the indications to request for reconstruction of congenital anomalies beyondchildhood were not necessarily due to loss of function but to increase opportunities for employment, improvedappearance and hope for increased function. The results may aid in the understanding of the natural history ofcongenital hand anomalies and guide the physicians with more specific advice for parents with children presenting with these conditions.