This child's left hand is a bit different from other kids'. On the adorable thumb, there's a little "horn" - this is Type II polydactyly.
First consultation
They came all the way from Ürümqi. A trip to Wuhan is nearly 3,000 kilometers - almost crossing half of China. Their purpose was simple: they wanted their child's hand to be like every other child's. So they hurried to bring their 4-month-old baby to Wuhan to see me.
What to do with Type II polydactyly?
Although the parents had done some research about polydactyly before coming, they were still nervous and anxious. What concerned them most was how to approach the surgery - is it just a matter of removing the extra thumb?
For this type of Type II polydactyly, there's really no need to be too worried. Its main feature is the bifurcation of the distal phalanx, which makes the child's thumb look wide and unusual in appearance.
Preoperative X-ray
Which thumb should be removed? This is always the first question parents ask. Looking at the child's fingers, the outer thumb is relatively smaller, so it can be removed.
But removing it is not the end - we also need to correct the deviation of the remaining thumb's tip, and ensure the stability of the interphalangeal joint.
In this process, the postoperative use of a Kirschner wire (K-wire) is essential. It's used for internal fixation to give the thumb a stable environment to recover after surgery.
After understanding the surgical plan, the parents finally felt some relief. Since the journey was so far, they wanted to learn every detail.
The first concern was about anesthesia. This is something many parents worry about. The child's mother asked me:
First consultation
1. Is it safe to use general anesthesia for polydactyly surgery at 6 months old?
The baby was 4 months old at the time. Around 6 months, once the baby's weight and other factors meet the surgical criteria, the surgery can be done. But the mother was still worried whether the child could handle it.
Actually, whether the surgery is done around 6 months or later, a short session of general anesthesia has very minimal impact on the child. It won't affect the baby's intellectual development.
2. Why should polydactyly surgery be done early?
The younger the baby, the better the plasticity of the fingers. Early surgery helps the thumb recover better.
Otherwise, as the child grows, not only will the extra thumb remain unresolved, but the condition may become more complex, and the surgery would be more difficult.
3. The mother has a keloid-prone constitution. Will the child inherit this?
The mother was also worried about scarring because she has a keloid-prone constitution and feared it might be inherited by the baby. If the scar becomes too obvious, it could affect the healing.
Scarring is indeed something parents should pay attention to after surgery. However, as for keloid-prone constitution, there is currently no strong evidence of hereditary patterns. So there's no need to carry such a heavy mental burden. Just follow the doctor's advice - wear the brace properly and use scar-reducing medication. Of course, always monitor the scar's progress. If anything unusual happens, contact us immediately.
Faint scar, thumbs up!
Fortunately, the mother's concerns about keloid constitution did not pass on to the baby. When the baby stretches out the thumb, no one would imagine that the "horn" once grew on this very thumb. Now the thumb is chubby, and the baby can raise it high to give mom and dad a big thumbs-up.
6 months after surgery
6 months after surgery
The parents really did a great job. The child's hand is the best proof - the quality of care shows in the results. Not only is the scar faint, but the shape and posture of the thumb are also excellent.
But the work isn't over yet - parents shouldn't relax. They need to keep working on the thumb's functional training so it can continue to improve.