Removal of simple accessory digits may be possible with local anaesthetic in a child under 3 months while they are distracted by feeding. For more significant congenital hand conditions such as duplication of the thumb, or syndactyly (webbing) of the fingers a general anaesthetic procedure is needed and skin grafts may be necessary. Surgery is not usually performed before the age of 12 months and usually can be done as a day stay procedure. The time taken per procedure is variable, in line with the individual nature of this type of condition. For trigger finger or thumb, surgery may be necessary but in some instances referral to hand therapy may be suitable.