The spectrum of hand malformations is vast and includes the very complex deformities as well. Early treatment is our primary goal focusing on the function and form of the hand. Syndactyly (partial or total fusion of neighboring fingers) is one of the malformations that are being treated in our Plastic Surgery Department in Berlin . Further more, the double thumb or polydactyly(supernumerary fingers) und phokomelia (not or partially developed fingers) are also treated in our clinic. An early presentation of the affected child can help the parents and the therapists to co-plan and develop a treatment regimen to which the surgeon, paediatrician, paediatric orthopedist, physiotherapist, hand splints manufacturer etc. are actively involved and committed.