Digital Lengthening

Shortened digits are a common concern of parents when their child is born with a difference. For most kids, lengthening does not make sense as it will not improve function or appearance. However, for some kids, the procedure can make a big difference. The most common situation is amniotic constriction band in which digits are […]

2 Reasons for Less than 5 Fingers

 A brief post with lots of pictures and videos on two conditions that may cause less than five fingers.  As I have previously written, there are 5 common causes.  Parents have given permission. Diagnosis 1.  Symbrachydactyly.  This patient has a great thumb and nubbins past the metacarpals.  However function is excellent.  The child will likely […]

Pollicization Long Term

Hello all.  I want to share a good result in a challenging pollicization procedure.  This patient has radial longitudinal deficiency with a poor, very limited thumb (we call it type 4 hypoplastic thumb).  The decision was made to excise the thumb and create a new one with the index finger (e.g., the pollicization procedure).  We […]

Amniotic Constriction Band- how we can help function

Amniotic constriction band is a common condition which typically involves more than one extremity.  While the belly and face can be involved in rare patients, the arms and legs are the classic sites.  Every child with amniotic band is different.  Totally.  Sometimes, physicians refer to it as a syndrome but that is not really accurate- it is a random pattern of constriction rings, […]

Making a More Functional Hand

I have written numerous times in this blog about the importance of improving function for kids born with hand differences.  Function can be made better through therapy, through splinting, or through surgery. Whenever possible, we want to improve appearance as well.  There have been several investigations that found that kids born with hand differences are […]

Hand Limitations in Ulnar Longitudinal Deficiency

My mentor, Paul Manske, clarified years ago that the hand is often the greatest limitation for children with ulnar longitudinal deficiency in this classic ARTICLE.  And, as I have previous blogged HERE, the hand limitations can manifest in many different ways.  There are many different ways this presents in ulnar longitudinal deficiency including: thumb and index finger webspace tightness, […]