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Pediatric
Hand Surgery
GiorgioPajardi
Editor
123

Pediatric Hand Surgery

Giorgio Pajardi
Editor
Pediatric Hand Surgery

Editor
Giorgio Pajardi
Department of Hand Surgery and Rehabilitation
S.Giuseppe MultiMedica Hospital, Milan University
Milano, Italy
ISBN 978-3-031-30983-0 ISBN 978-3-031-30984-7 (eBook)
https://doi.org/10.1007/978-3-031-30984-7
© Springer Nature Switzerland AG 2023
This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or
part of the material is concerned, specically the rights of translation, reprinting, reuse of
illustrations, recitation, broadcasting, reproduction on microlms or in any other physical way,
and transmission or information storage and retrieval, electronic adaptation, computer software,
or by similar or dissimilar methodology now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this
publication does not imply, even in the absence of a specic statement, that such names are
exempt from the relevant protective laws and regulations and therefore free for general use.
The publisher, the authors, and the editors are safe to assume that the advice and information in
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the authors or the editors give a warranty, expressed or implied, with respect to the material
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neutral with regard to jurisdictional claims in published maps and institutional afliations.
This Springer imprint is published by the registered company Springer Nature Switzerland AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland

To my grandchildren Beatrice, Tommaso and Alice,
https://t.me/medicina_free
who carry our projects and our dreams into their future.

Preface
https://t.me/medicina_free
When 8 years ago Elisa Geranio from Springer suggested that I should write
this book, I asked her to have a few days of meditation before answering. I
love challenges and I love overcoming them even more, but I imagined that
selecting and coordinating so many colleagues on such a niche topic would
have been a truly demanding undertaking right from the start. So it was, but I
am happy to have accepted the proposal and I hope the readers of these pages
are as well.
The theme is fascinating and always current. Congenital malformations of
the hand can hardly be caged in rigid classications and certainly do not
respond to preordained reconstructive schemes.
Scientic rigour, experience and dexterity of the surgeon are useless if
they are not spiced up with imagination, which allows us to project what we
are building today into the dimension of growth, thinking of the dexterity of
what will be a child and then a young adult.
A heartfelt thanks to all my Friends—who I hope will remain so in the
future, despite my harassment- who have responded to my appeal by giving
us the precious gift of their experience.
Thanks to my team, who contributed in every way to complete the work,
transfusing years of coaching in my paediatric clinics and operating rooms.
They are my future because unlike the other branches of hand surgery, the
paediatric eld requires at least fteen years of experience to see the result in
the young adult of what was decided during the rst visit a few days after
birth.
Special thanks to Chiara Novelli, who was able to support and solicit
Colleagues from all over the world, avoiding that the effort and at times the
disappointment for some delay could let them run out of enthusiasm. Thanks
to the Publisher for the honour reserved for me and my country, offering me
this unique and unrepeatable experience.
Last but not least, thanks to my wife and daughters who have always sustained and supported me actively in my human and professional choice,
which is difcult and certainly not commercial, supporting the families with
the “Associazione la Mano del Bambino” and during the tiring process of
care, with a special dedication to my daughter Martina who has tenaciously
chosen to follow me in the most rewarding profession that exists.
Milano, Italy GiorgioPajardi
vii

Contents
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1 The Congenital Hand: Psychological Aspects . . . . . . . . . . . . . . . 1
Daniela Pajardi and Alessandra Viano
2 Babies Hand Imaging and X-ray . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Gaetana A. Rispoli and Maurizio Zompatori
3 Hand Defects: An Isolated Anomaly Or a
Syndromic Disease? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Angelo Selicorni, Paola Cianci, Silvia Tajè,
and Massimo Agosti
4 Paediatric Trigger Finger . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Chiara Novelli and Giorgio Pajardi
5 Camptodactyly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Chiara Parolo, Elisa Rosanda, and Giorgio Pajardi
6 Syndactyly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Daniel M. Weber
7 Symbrachydactyly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
Elisa Rosanda, Chiara Parolo, and Giorgio Pajardi
8 Central Synpolydactyly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
Andrea Jester, Tatiana Y. Jacomel, Michail Vourvachis,
and Jeannette W. C. Ting
9 Thumb Polydactyly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Christianne van Nieuwenhoven and Steven Hovius
10 Ulnar Polydactyly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
Scott N. Oishi and Terri Beckwith
11 Cleft Hand or Split Hand Foot Malformation . . . . . . . . . . . . . . . 123
Stéfane Guéro
12 Brachydactyly Types D and E . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
Zavarukhin V. Ivanovich
13 Surgical Management of the Blauth 1 to 3A
Thumb Hypoplasia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153
Stéphane Guéro
ix

x
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14 Thumb Hypoplasia: Genesia, Pollicization . . . . . . . . . . . . . . . . . . 167
Giorgio Pajardi, Elisa Rosanda, and Chiara Parolo
15 Radial Longitudinal Deficiency: Classification
and Surgical Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175
Steven E. R. Hovius, Martijn Baas,
and Christianne A. van Nieuwenhoven
16 Progressive Bone Distraction Lengthening in the Treatment
of Congenital Malformations of the Upper Limb . . . . . . . . . . . . 189
Mario Paracuollo, Chiara Novelli, Giulietta Proserpio,
Keit Young, and Giorgio Pajardi
17 Radial Club Hand: Microvascular Reconstruction . . . . . . . . . . . 203
Simo K. Vilkki
18 Metacarpal Synostosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219
Anna M. Acosta and Terry R. Light
19 Epidermolysis Bullosa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235
Chiara Novelli, Chirara Parolo, Veronica Fasoli,
and Giorgio Pajardi
20 Arthrogryposis: Introduction and Classification . . . . . . . . . . . . . 245
Olga Agranovich
Contents
21 Thumb in Arthrogryposis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 251
Chiara Novelli, Giulietta Proserpio, and Giorgio Pajardi
22 Vascular Malformations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255
Luciana Marzella and Piero di Giuseppe
23 Macrodactilies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269
Scott N. Oishi, Marybeth Ezaki, Terri Beckwith,
and Arena Sayavong
24 Palliative Surgery in Obstetrical Brachial Plexus Palsy . . . . . . . 283
Filippo M. Senes, Nunzio Catena, and Chiara Arrigoni
25 Nerve Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 301
Filippo M. Senes, Nunzio Catena, Luigi A. Nasto,
and Chiara Arrigoni
26 Flexor Tendon Lesions in Children: Diagnosis,
Treatment, and Early Active Motion Rehabilitation . . . . . . . . . . 309
Chiara Parolo, Greta Culicchia, Rossella Pagliaro,
and Giorgio Pajardi
27 Pediatric Hand Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 315
Filippo M. Senes, Luigi A. Nasto, Nunzio Catena,
and Chiara Arrigoni
28 Replantation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 329
Mona I. Winge and Magne Røkkum

Contents
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xi
29 Hand Transplantation in Children . . . . . . . . . . . . . . . . . . . . . . . . 353
Shaun D. Mendenhall, Todd J. Levy,
Sandra Amaral, Benjamin Chang, and L. Scott Levin
30 Rehabilitation in Pediatric Hand Trauma . . . . . . . . . . . . . . . . . . 367
Rossella Pagliaro, Luigi Bartolomeo, Silvia Minoia,
and Elena Marta Mancon
31 Toe-to-Hand Transfers for Posttraumatic and
Congenital Reconstruction in Children:
Indications and Surgical Technique . . . . . . . . . . . . . . . . . . . . . . . 377
Neil Jones and Chiara Parolo
32 Compartment Syndromes (CS) and Volkmann’s
and Upper Limb Vascular Pathology in the
Peri- and Neonatal Period . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 391
Antonio Landi, Giuesppe Caserta, Andrea Giorgini,
Silvana Sartini, and Scott Oishi
33 Postoperative Dressings and Care . . . . . . . . . . . . . . . . . . . . . . . . . 415
Ellen Kroin and Terry R. Light
34 Rehabilitation in Congenital Hand and Forearm Defects:
Rehabilitation of the Child’s Hand—General Aspects . . . . . . . . 423
Elena M. Mancon, Luigi Bartolomeo, Elisa Ceccarelli,
Sara Cesaroni, Claudia Corsi, Greta Culicchia, Ambra Gelatti,
Roberta Genova, Antonella Guerriero, Sara Longhi,
Claudia Maiolino, Carmen Meloni, Silvia Minoia,
Marta Nobilia, Rossella Pagliaro, Stefania Paparo,
Valeria L. Petrillo, Michela Ramella, Federica Suriano,
Patrizia Rossi, Francesca Tolosa, and Simona Vecchi
35 Association to Support Babies and Families. . . . . . . . . . . . . . . . . 475
Amy Lake, Martina Pajardi, and Elena M. Mancon
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 481

The Congenital Hand:
https://t.me/medicina_free
Psychological Aspects
DanielaPajardi andAlessandraViano
1
Abstract
The hand is fundamental to human psychosensorial development and becomes a means
and a symbol of autonomy because it can
reach every area of the body. Furthermore,
hands play a central role in social and emotional relationships because they express emotionality, they are protagonists in nonverbal
communication, and they are also constantly
visible to others as well as to their owner.
The relationship between patient and health
specialists grows and is shaped in this difcult, emotionally intense context. Health personnel face a problem that requires joint and
coordinated intervention from various professionals: surgeons, physiotherapists, and psychologists. Especially when the patient is a
child there is a complex interaction between
health workers, children, and their family system. The psychological and emotional aspects
can have an impact in terms of compliance
with the therapeutic plan, relationships, and
quality of life.
D. Pajardi
Department of Humanities, University of Urbino,
Urbino, Italy
e-mail: daniela.pajardi@uniurb.it
A. Viano (*)
Department of Hand Surgery and Rehabilitation,
San Giuseppe Hospital IRCCS MultiMedica,
Milan University, Milan, Italy
Keywords
Hand congenital malformation · Hand
disgurement · Multiprofessional approach ·
Decision making · Parenting stress
The functionality and visibility of the hand make
this body part full of emotional meaning. The
team that deals with conditions and pathological
conditions involving the hand needs to face the
psychological aspects raised by such an important part of the body.
The hand is fundamental in human psychosensorial development and becomes a means and
a symbol of autonomy as it can reach every part
of the body. When people lose the possibility of
carrying out these actions on their own, they
markedly lose independence. Furthermore, it is
important to remember that hands play a central
role in social and emotional relationships because
they express emotionality: we caress with the
hand. The hand is the protagonist in nonverbal
communication, but is also constantly visible to
others as well as to its owner.
When a person is faced with traumatic or malformity problems, this latter aspect is important
from a motivational point of view: the subject
cannot avoid confronting his/her own difculties
and reactions raised in the social context.
Therefore, visibility is an element that sustains
and pushes toward the need to elaborate and
accept one’s own condition or the condition of
© Springer Nature Switzerland AG 2023
G. Pajardi (ed.), Pediatric Hand Surgery, https://doi.org/10.1007/978-3-031-30984-7_1
1
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