Abstract
Congenital hand anomalies can cause substantial functional problems. There are multiple situations where there is lack of stable pinch and/or grasp that can be improved by surgical intervention. An example of reconstructive surgical intervention in each of three specific congenital hand anomalies is presented: hypoplastic thumb, absence of the fingers, and insufficient length and stability of the digits. Focus is on the approach to the patient, surgical treatment and the goals achieved. It is important to mention that other techniques may be preferred by other surgeons, and may also yield excellent results.