Children’s Hand Surgery

Since 1988, Paul Smith has developed and led the Congenital Hand Surgery service at Great Ormond Street Hospital and gone on to practice at the Portland Hospital in London, taking with him the experienced medical team he had spent time developing.He is proficient in delivering a wide spectrum of children’s hand surgical procedures, including congenital transverse amputation, symbrachydactyly, radial club hand, ulnar club hand, syndactyly, acrocephalosyndactyly’s such as Apert’s Syndrome, hypoplasia (especially thumb hypoplasia), duplication and Ring Constriction Syndrome.

His experience in this field is such that he has treated over 170 radial club hands, 6 mirror hands, over 300 thumb hypoplasias, requiring in excess of 140 pollicisations and over 120 Apert’s syndactyly’s. There are only two other centres in the UK that can be said to have anywhere near this degree of expertise. His Clinical Nurse Specialist Rachel Hall has 20 years experience in Congenital Hand Surgery.

Paul treats the full range of congenital hand deformities as listed below:

Failure of Formation of Parts:

      • Transverse Absence
      • Longitudinal Absence
        • Radial Club Hand
        • Cleft Hand
        • Ulnar Club Hand

Failure of Differentiation of Parts:

      • Radio-ulnar synostosis
      • Symphalangism
      • Campodactyly
      • Clinodactyly
      • Trigger thumb
      • Clasped thumb
      • Arthrogryposis
      • Syndactyly
        • Complex Syndactyly
        • Apert’s Syndactyly

Duplication or Polydactyly

      • Thumb duplication
      • Central digital duplication
      • Duplication of the little finger
      • Mirror hand


      • Macrodactyly


    • Thumb Hypoplasia – Thumb reconstruction and Pollicisation including Triphalangeal thumb
    • Madelung’s Deformity
    • Kirner’s Deformity

Constriction Ring Syndrome