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Examination

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Examination of the child with a congenital hand anomaly is carried out in a relaxed environment, ideally with the child interacting with the parent or a play specialist. Various toys or games which require manual dexterity can be used gradually to elucidate function. Once the confidence of child and family have been attained, a full musculoskeletal examination is undertaken:

  • hand to chest wall:
    • extent of deformity
    • attitude of hand
    • posture of limb
    • wasting or compensatory hypertrophy of muscles eg absence of pectoral muscles with Poland's Syndrome
    • passive range of motion
    • gross active range of motion at each joint; generally difficult to measure in all but the older child
    • examination of contralateral side; many congenital upper limb anomalies are symmetrical
  • examination of feet for equivalent anomalies eg syndactyly, clefts
  • abnormalities in other systems:
    • distinct syndromic facies eg Down's Syndrome, Apert's Syndrome, Freeman-Sheldon Syndrome
    • scoliosis
    • Sprengel's deformity
    • knee deformities
    • hypoplastic mandible
    • deafness
    • ocular abnormalities
    • heart murmurs eg due to ventricular septal defects
    • cleft lip
    • cleft palate
    • imperforate anus

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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