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To the best of our knowledge, this is the first report of an operated case of an isolated, bilateral, and sporadic typical split hand malformation.

Surgical or medical co-morbidities of anesthetic or airway difficulties in patients with congenital anomalies need special consideration during corrective management, especially in the pediatric population.[1-4] Split hand malformation (SHM), characterized by median cleft in the hand, syndactyly, and/or a variable degree of underdevelopment of phalanges and metacarpals, is a rare entity.[5,6] Associated co-morbidities can include sensori-neural hearing loss which can be challenging to identify when eliciting history during preanesthetic evaluation or during the anesthetic induction as such patients can be difficult to counsel.

Preanesthetic evaluation revealed no systemic or airway challenges and parents were counseled for routine surgical and anesthetic risks.

The hands underwent successful surgical reconstruction with no peri-operative complications.

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We report a case of bilateral typical cleft hand in a 6-year-old male.

There was no positive family history of such presentation, and no systemic manifestations were associated with this entity.

The literary evidence indicates the occurrence of multiple anomalies with SHM, but a literature search for isolated cleft hand anomaly yielded only two results.[5,6] The reported cases in the literature described only unilateral afflictions.

We report a unique case of sporadic, isolated, bilateral SHM with syndactyly in both feet, which was successfully managed surgically and anesthetically with no untoward peri-operative incidents.

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