It seems clear to me that 3D printed myoelectric prostheses are the future for upper extremity prosthetics in all age group but especially for kids. These prosthetics can be customized, are developed/ fabricated quickly, can be replaced for a low price, and have so much potential. I am hoping and expecting real progress over the […]
Year: 2018
Severe Radial Deficiency, Before and After
I have posted numerous times on radial longitudinal deficiency. The birth anomaly is common in my practice and I have been fortunate to meet many great kids and families with radial deficiency. A few posts can be seen HERE. Early in my career, as influenced by my training, most patients with radial deficiency were treated with […]
Thumb Web Space in Amniotic Band
Amniotic Constriction Band is a common condition which affects each child differently. It can lead to syndactyly (joining of fingers), amputations, or deep bands which limit function. It often affects more than one extremity (ie, hands and feet) making efforts to maximize function really important. I have posted many times on amniotic band- those posts […]
Severe Radial Deficiency- No slowing this kid down!
The absolute best part of my job is meeting so many great kids and great families. What other job allows daily inspiration, with each day being a bit different with a new story, a new set of expectations exceeded, and many, many smiles. This is the abbreviated story of one amazing child and family with […]
Untreated Cleft Hand
Cleft hand is one of the most notable birth anomalies of the upper extremities. The appearance is distinctive although function can be really well maintained. One of the founding fathers of the discipline of hand surgery, Sterling Bunnell, labeled cleft hand, “a functional triumph and a social disaster”. There are other names for cleft hand. […]
Radioulnar Synostosis
Radioulnar synostosis is the presence of a bony connection between the radius and ulna. I have previously blogged a few times on it HERE. While a synostosis can develop after a trauma, we typically discuss it when present from birth. The synostosis prevents forearm rotation but does not affect elbow or wrist motion (these are […]
Unusual “Extra” Finger
I have posted many times on polydactyly- both on the thumb side and the pinky side- as can be seen HERE. The following patient demonstrates an unusual presentation of what initial appears to be an extra finger, an ulnar polydactyly. But, as a quick ‘count’ confirms, there are only 4 fingers with a thumb. Ulnar deficiency […]
Function in Radial Deficiency
Radial longitudinal deficiency is both a functional challenge and an appearance issue. Different surgeons have developed different strategies based on these challenges and the lack of a ‘perfect’ surgery. My philosophy is to consider different surgeries, based on the child. I will consider centralization (typically with a period of external fixator distraction prior to the […]
Trigger Thumb and Fingers
Trigger thumb is one of the more common reasons for kids to present to my office. While uncommon in the general population, for hand surgeons who treat children, trigger thumb is quite common. And, thankfully, kids do quite well with this condition. Some will improve on their own without surgical intervention and others require surgery […]
Extra Thumb Reconstruction
I have posted a number of times on radial polydactyly- aka split thumb, extra thumb, etc- HERE. This is a common birth anomaly and the decision for surgery is usually straightforward. Sometimes surgery is also straightforward while other times the reconstruction can be quite challenging. And, about one out of three patients with radial polydactyly will […]
Families, Choices, and Untreated Triphalangeal Thumbs
One of the benefits to my taking care of kids with birth anomalies of the upper extremity is the opportunity to really come to know the patient and the family, often over many years. This is magnified when more than one child is affected. This is one of the best things about my practice (and […]
Three thumbs
Radial polydactyly (duplicated thumb) is an uncommon condition in the general population- I have blogged about kids with extra thumbs a number of times. Those posts can be found HERE. Extra thumbs come in a wide variety of patterns, some of which are captured in the Flatt Classification (previously called the Wassel Classification) as shown in […]
Mission Trip
I wanted to share the experience of my first Mission Trip. I went with the World Pediatric Project (WPP), a wonderful organization with which I have a long relationship. I have cared for many of their patients in the US but have not traveled with them (or any other organization). Their website, which can be […]
Ulnar Deficiency Follow Up
Hand surgery is a great subspecialty. I am able to interact and treat many patients and I am rewarded in seeing my patients get better. However, there is a downside which is that I rarely follow patients long term. Typically, I am able to see them, provide treatment (whether that be therapy, injection, or surgery) […]
Surgery for Camptodactyly
Camptodactyly is the bent (flexed) position of a finger. I have previously blogged about camptodactyly HERE, but wanted to share my updated surgical strategy. Surgery is considered for camptodactyly when therapy is not expected to be effective or if therapy has failed to lead to improvement. It is absolutely my preference to always begin camptodactyly treatment […]
Macrodactyly, Syndactyly, and Keloid
Macrodactyly is very rare, even at centers such as ours that evaluate and treat many kids with birth anomalies of the upper extremity. Macrodactyly is a difficult condition to research as there is so much variability in presentation- fingers may be dramatically large, moderately large, or only slightly larger than the expected finger size. Treatment […]
Travel and News
Happy 2018! I hope it is a great one for you and your family. Well, I already have one resolution for 2018- blog more consistently. I am not meeting my goals and hope to do better in this new year. A few things to share. I had a wonderful trip to Japan as guest speaker […]