More thoughts on Pollicization The decision to proceed with pollicization is not easy. It is most straightforward when the thumb is completely absent and is most difficult when the child has any thumb, as families very reasonably would like to keep and improve the small thumb rather than excise it and pollicize the index finger. […]
An extra thumb has been labeled many different ways: ‘radial polydactyly, thumb polydactyly, split thumb, and duplicated thumb’. My preferred name is radial polydactyly as it tells you exactly the issue. The term ‘duplicated thumb’ is not ideal as the thumbs are both smaller than normal but ‘split thumb’ is not perfect either because the […]
Taking the word literally, “sym” means joined (like “syn”), “brachy” means short and “dactyly” means finger= short, joined fingers. However, symbrachydactyly comes in many different forms. In fact, some forms of symbrachydactyly don’t have developed fingers at all. We can classify symbrachydactyly in 4 basic types- these are helpful for discussion. – Short finger type- fingers […]
Patient with arthrogryposis after rotation of left arm but before surgery on right arm and before wrist surgery. One of the many challenges in the child with arthrogryposis is internal rotation of the arms (arms rotated towards body). This can make functional activities like bringing the hands together difficult. It can be tough to even […]
I am sitting in the Tokyo airport awaiting my plane to fly back to the USA. Had a great 4 days in Vietnam with an international group of congenital hand surgeons. I was flattered to be asked to join the meeting. I arrived a day early so had a chance to tour Ho Chi Minh […]
Pollicization is the hallmark congenital hand surgery. It is performed for patients with absent or severely diminished thumbs. The thumb is vital for overall hand function and in adults, it is estimated that the thumb provides 40% of hand function. A normal or reconstructed thumb allows for grasp of large objects (think: soda can), a […]
What is Ulnar Longitudinal Deficiency (dysplasia)? Ulnar Longitudinal Deficiency (ULD) is a lack of formation of the pinky side of the upper extremity. It usually affects the forearm but can affect the hand, forearm, and upper arm. It can affect bone, muscle, tendon, nerves, and blood vessels. The severity is different in each affected child. […]
Recently, I took two hand surgery related trips. First, the American Society for Surgery of the Hand was in Las Vegas at the beginning of September this year. Not my favorite city but certainly a good place for a conference. This meeting is always very educational and provides a wonderful forum for discussion on general […]
Syndactyly involving all 4 fingers. Much less common presentation. Likely to have bony involvement.
Syndactyly between the long and ring fingers. The most common appearance. Skin involvement only.
What is Radial Longitudinal Deficiency (dysplasia)?Radial longitudinal deficiency (RLD) is a lack of formation of the thumb side of the upper extremity. It can affect the hand only (usually the thumb) or, more commonly, the hand and forearm. It is a lack of bone, muscle, tendon, nerves, and blood vessels. The severity is different in […]
Dr. Goldfarb has the answers: 1.When should surgery be performed?There are no firm guidelines on the timing of surgery for syndactyly but some basic principles apply.•Thumb- index finger syndactyly or ring- small finger syndactyly should be corrected early. Many surgeons will consider surgery between 3 and 6 months for these syndactylies.•Index- long finger and long- […]
What is SYNDACTYLY?Syndactyly is the abnormal connection of 2 fingers. Most commonly, it is a webbing between 2 fingers- the middle and ring fingers. However, it can involve any two fingers or can involve the thumb and pointer finger. It can also involve more than 2 fingers. The webbing can involve the entire 2 fingers […]