Saturday, May 20, 2017

Hand Anomalies and Adoption

Adopted Kids and Polydactyly

In 2015 (the most recent year with statistics available), there were 5647 children adopted to parents in the USA.  About half of those were from China.

I am fortunate to see many families with newly adopted children.  It is one of the most enjoyable parts of my practice.  Sometimes I am able to assess the paperwork prior to the actual adoption to provide information for families seeking to better understand the challenges that adoption may bring. To meet these amazing families that have traveled across the world to adopt kids in need is such a pleasure.  These children are brought to see me for one of three reasons:
1)    To assess an upper extremity difference that has not been treated
2)    To assess an upper extremity difference that has been treated, perhaps well and perhaps in a less than ideal way
3)    To generally assess the child (least common).

I admit that these kids and families are some of my favorite to treat.  The joy the families bring and the interest in learning more about their new child’s upper limb difference is powerful.  There are added complexities in treating newly adopted kids including the social aspect of the adoption.  The adopted child takes time (variable) to adjust to the new home environment, their new family (possibly new brothers and sisters), etc.  While there may be a notable limb difference, we do not rush to treat the patient.  We might institute therapy or splinting but our primary goal is to give the families as much time as needed to limit any additional ‘trauma’ that surgery might inflict.  We do recognize that some families are eager to move forward but patience is typically our goal.

This is a newly adopted 4- year old child who was previously treated in China.  I believe that she had radial polydactyly (extra thumbs on each hand) and was treated with excision.  While she functions well, there is an appearance difference on both thumbs and some discomfort when bumped, especially on the left.  The right side is in a better condition- it is somewhat stiff with mild angulation.  Motion is limited on both sides but more so on the right (although there is no pain).

When the time is right, we will consider surgical reconstruction to better align the thumbs.  The right thumb, on top, is better aligned.  The left thumb (below) has the bump which represents a part of the extra thumb which was only partially excised in China.

Charles A. Goldfarb, MD
My Publication List

Media Links

I would like to share a few media links which I have enjoyed.  The first is from the New York Times- LINK- on the 3D printed prosthetic.  Interesting read and highlights some of the information we have also shared: My Blog's 3D printed information.

Additionally, the St Louis Post Dispatch recently shared a great story about one of our patients with a myoelectric 3D printed prosthetic.  We are still working out some minor kinks (related to myoelectric firing of the prosthesis) but she is doing great.  Check it out HERE.

Finally, the Shriners Hospital in St. Louis just opened a new lab, creating an amazing collaboration between the Shriners Hospitals, Washington University School of Medicine, and the Department of Orthopaedic Surgery.  We are fortunate to have Farshid Guilak at the Shriners to direct the lab and the research program.  The new lab is profiled HERE.  Farsh joins Michael Whyte who's fantastic bone research in kids has led to some groundbreaking discoveries on rare diseases and the entire Orthopaedic team.  We believe this multifaceted approach will change orthopaedic research and, through translation discoveries, change orthopaedic care for kids (and adults) over the years to come.

Charles A. Goldfarb, MD
My Publication List