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A congenital anomaly is one noted at birth. Anomalies can be relatively minor (such as an angulation of the small finger: clinodactyly) or can be more major (such as hypoplasia or absence of the thumb). The care of children with congenital hand anomalies usually involves a team of healthcare professionals, including hand surgeons from the BSSH. Most congenital-hand surgery is carried out in hospitals with experience in the care of children.