Congenital and acquired anomalies of the hand can impact a child’s ability to develop and explore the world normally. Corrective surgery can be performed, allowing the child to have improved function and appearance. Dr Thomas is appointed at The Royal Childrens Hospital, Melbourne as one of the Paediatric Hand and Microsurgeons. He is also a member of the multidisciplinary team that treats obstetric brachial plexus palsy. Reparative surgery to a child’s hand is best performed by a qualified and experienced surgeon.

Candidates for Paediatric Hand Surgery

Patients that qualify for paediatric hand surgery include those with the following concerns:


Also known as “webbed” fingers or toes, this condition is characterised by the fusion of two or more digits. In some cases, the fusion only involves the soft tissue between the fingers, but more severe cases include fusion of soft tissue, bone and nail.


One of the most common types of congenital hand deformity, polydactyly is characterised by the growth of an extra digit. The additional finger or toe is often a duplicate of the little finger or thumb, but other fingers and also toes can also be affected by this condition.


This condition features either missing or short fingers that cannot function normally. The thumb is generally unaffected, with the condition commonly involving only one limb.

Underdeveloped Thumbs 

Also known as thumb hypoplasia, this condition results in a thumb that is abnormally small with possible deformities to the muscles, joints, and bones. In some cases, the thumb may be missing entirely.

Obstetric Brachial Plexus Palsy 

Obstetric Brachial Plexus Palsy can happen as a result of a newborn that has had difficulty passing through the birth canal. The large network of nerves that run between the neck and shoulder are known as the Brachial Plexus. When nerves are temporarily or permanently damaged, a combination of reconstructive surgery and physiotherapy may be the best treatment to optimise the arm and hand function.

About the Procedure

Paediatric hand surgery is typically performed under general anaesthesia and may require an overnight stay in a hospital, depending on the specific procedure performed. Surgery is typically recommended as early as possible to avoid impeding the child’s normal development. However, some surgeries can be delayed for some time, depending on the type of surgery needed and the risks involved. Dr Thomas will work with patients to help them determine the best timing for surgery for their child.

See Before and Afters


Recovery from hand surgery varies, based on the specific procedure performed. Some children will be back to regular activities within a few days, while others may take longer to heal. Post-operative hand therapy will likely be needed after surgery to help the patient regain optimal function of the hand. Dr Thomas partners closely with physiotherapists and occupational therapists to promote a full recovery after the procedure. 

Surgical correction of a congenital hand deformity is typically the best option for restoring optimal function to the hand and providing an aesthetically pleasing result. To learn more about options in paediatric hand surgery, contact Dr Thomas on 03 9034 7738.