The assessment and diagnosis of a congenital hand anomaly should be undertaken in a center with a specialist interest in such problems. Usually, such centers have the advantage of input from multiple specialities as part of a multidisciplinary team including:
Multiple assessments in a relaxed environment are typical in order to ascertain the level of function. Typically the family have a range of questions about the diagnosis, treatment and genetic inheritance. They may need social and psychological support beyond the immediate sphere of the surgical management of a congenital hand deformity. For example, there is frequently a misplaced sense of guilt on behalf of the parents that in some way they were responsible for the condition. Equally, if the child has multi-systemic abnomalities, there is the major burden of longterm care for the family with all of the financial strain that this produces. As well as an ongoing dialogue with the paediatric hand team, the patient and family may benefit from introduction to support groups and meetings with older patients with similar clinical conditions.
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