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. https://travel.state.gov/content/adoptionsabroad/en/about-us/statistics.html
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
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