Objective To explore the management effects of unplanned preoperative discharge in children with congenital hand and foot deformities. Methods A historical controlled study was conducted.From April 2020 to April 2023, a total of 412 children with congenital hand and foot deformities were selected as a pre-management group, receiving routine preoperative treatment and nur-sing care.Logistic regression analysis was used to identify the influencing factors of unplanned preoperative discharge, and targeted management strategies for unplanned preoperative discharge were developed.From June 2023 to June 2025, a total of 402 children with congenital hand and foot deformities were included as a post-management group, applying the management strategies for unplanned preoperative discharge based on the pre-management group. Results The rate of unplanned preoperative discharge, preope-rative anxiety scores and incidence of anxiety in parents of children in the post-management group were significantly lower than those in the pre-management group, and parents′ satisfaction towards nursing services was significantly higher than that in the pre-management group （all P＜0.05）. Conclusion Implementing management strategies for unplanned preoperative discharge in children with congenital hand and foot deformities is conducive to reducing the rate of unplanned discharge, alleviating parental anxiety, and improving parental satisfaction with nursing services.