Parents expect a child to be born perfect in every way. Coming to terms with a congenital hand difference can at first seem daunting. Feelings of guilt, remorse and a degree of sadness can occur. It is important for parents to be given time and space to be able to express these feelings. Parents are often bombarded with questions from other family members and friends, which can add to their frustration. Overall, given time and the correct support, parents go on to develop a very practical and well-adjusted view of their child’s condition.
A first consultation provides an opportunity for parents to express their concerns in a empathetic and supportive environment. During the first meeting we are able to provide parents with accurate information regarding what to expect in the future. The role of surgery in optimising function and cosmesis can also be discussed. This can be facilitated through the use of pictures and videos. The sharing of information between families is also very useful. It is often possible to put children and their parents in touch with other families who have children with similar hand differences.
Generally in terms of functionality children are very quick to adapt. As they grow children will use their hands to their maximum ability despite their differences. They, like all children, are keen to keep up with their peers and can often do so very successfully through many adaptive strategies. In terms of appearance hands are integral to body image and social interaction. During a day a child will see their hands more often than they see their own faces. Generally children generally grow to accept they are different and are able to integrate well but there are times when they require some extra support. Initially a degree of innocence exists amongst children, which can persist for many years. However over time questions from inquisitive friends and unwanted attention from ‘newer’ groups of peers can lead to self-consciousness. Learning to deal with this attention and developing positive body image strategies is important for a child’s development.
Overall the main aim of treatment is to optimise a child’s function by enabling them to get as much from their hands as possible. Enabling a child to develop independence will help them reconcile their differences and help build their confidence. Hand differences become less noticeable when a child incorporates their hand into function. Maximising function, cosmesis and psycho-social well-being are the ultimate goals.