A child with cleft hand has a central V-shaped gap in the hand. The child may be missing one or more digits, but the small (pinky) finger is always present. 

If your child has a cleft hand, specialists at University of Missouri Children’s Hospital help your child improve function and work with you and your family through every step of the treatment process. Our experts are experienced in treating this condition compassionately and effectively so children can live a life with minimal limitations.

Children with cleft hand can be affected in a variety of ways, but usually both hands and both feet are involved. Often, despite an unusual appearance, these children demonstrate good hand function. Cleft hand is a rare, congenital (present at birth) hand anomaly. This condition has been known by several other names, such as ectrodactyly, split hand and lobster claw hand. Today, most prefer to use the term “cleft hand.”

Frequently asked questions about cleft hand in children

Check out answers to commonly asked questions about pediatric cleft hand.

Is this condition painful?

No, children typically do not feel any pain associated with this condition.

What are the different types of cleft hand?

Some children with cleft hand have a simple central gap in their hand, while others may be missing all fingers except for the small (pinky) finger. Like many of the congenital anomalies, the extent of cleft hand can vary greatly from child to child.

Who gets cleft hand?

Cleft hand is inherited as an autosomal dominant condition. This means that if you have cleft hand, there is a 50 percent chance of your child also inheriting the condition. In some cases, cleft hand may arise as a new genetic mutation in a child, even when the parents were not affected.

What causes cleft hand?

The exact cause of cleft hand is not currently known.

What are the main issues related to cleft hand?

The primary issue in cleft hand is function of the hand and digits. Other issues include:

• Appearance of the hand 
• Functional limitations (e.g. when there is only a small finger present)

A number of other anomalies have been observed in association with cleft hand. Some of these include: 

• Anomalies of the anus
• Anomalies of the eyes
• Cleft lip and palate
• Congenital heart disease
• Deafness
• Other bone and joint anomalies in the upper and lower limbs 

It is critical that an experienced pediatrician carefully and thoroughly examine all babies with cleft hand.

What is the treatment for babies with cleft hand?

We treat your child individually with a personalized treatment plan; however, some generalizations are possible. The primary goals of cleft hand surgery are to: 

• Close the cleft or gap in the hand
• Enable pinch and grasp function
• Reconstruct a functional thumb and first web space (the space between the normal thumb and index finger)

Our surgeons may perform one of many different surgical procedures, depending on your child’s needs. The timing and sequence of procedures is unique for each patient. In most cases, our surgeon will perform your child’s first procedure at or after one year of age.

What specialists will be involved in my baby’s care?

Most of the time your child will see a:

• Certified hand therapist
• Geneticist
• Hand surgeon
• Pediatrician

If our team detects other related problems, your child may see additional specialists.