Saturday, December 3, 2016

Simple Surgery for Symbrachydactyly

I have posted on several times on symbrachydactyly, with one post HERE.  Each child with symbrachydactyly, and really any birth difference of the upper extremity, is unique. No matter their bony and soft tissue deficit, their family situation and functional needs must also be considered.  So even if two kids look similar, I believe that musculoskeletal appearance is only part of the story- many other issues are considered.

This child has symbrachydactyly with a single digit (monodactyly type).  The thumb tip is flexed and he cannot straighten it.  His other extremity is normal.  Overall, he functions well.  The question that we discussed with the family is whether anything could be done to further improve his function.  Note the small palm which is typical in symbrachydactyly.

Symbrachydactyly with a single digit.

Symbrachydactyly with a single digit- side view.

Symbrachydactyly with a single digit- palm view.

Our team had discussions with the family and observed his function with activities.  Given that the thumb would not extend, together we all decided to position the thumb in extension with a stiffening of the joint (like a fusion but given the bony immaturity, technically not a fusion).  This more extended position should help with activities and will allow the patient to better use the hand for function.

Symbrachydactyly post surgery top view.

Symbrachydactyly post surgery- side view.

The pins will be in place for about one month and then he will use a splint temporary.  We look forward to this straightforward surgery improving function.

Charles A. Goldfarb, MD
My Bio at Washington University
My Publication List
congenitalhand@wudosis.wustl.edu


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