This baby is a classic case of Poland syndrome. The fingers of her right hand are relatively short, and all four fingers, except for the thumb, were fused together. Fortunately, her joints were stable. At six months old, we performed a surgery to separate all the fused fingers.
Before the surgery
"How could this happen? Our first child didn't have this issue."
When the delivery nurse brought the baby out and informed the parents about her small right hand and the presence of syndactyly (webbed fingers), the mother didn't think much of it at first. But upon seeing the hand, she broke down emotionally. She couldn't believe such a rare condition had affected her child. "Our first child didn't have this issue, and neither side of the family has a history of such conditions. Why is this happening to our second baby?"
Pre-surgery X-rays
Poland syndrome has a relatively low likelihood of being hereditary. It is often caused by disruptions during the baby's early development in the womb. Potential factors include maternal illnesses like colds or fevers, viral infections, medication use, radiation exposure, or even inhaling second-hand smoke. Identifying the exact cause is challenging.
When is the right time for surgery?
For cases like this, surgery is typically performed when the baby is 6 to 8 months old. At this stage, hand activity significantly increases, and fused fingers can visibly restrict movements. Separating the fingers during this period creates conditions for better hand activity, which, in turn, stimulates finger growth.
Before the surgery
How is skin deficiency handled after separating the fingers?
The parents were especially concerned about the surgical approach and wanted the one most beneficial to their baby.
After finger separation, there's usually skin deficiency. In Poland syndrome, this deficiency is more pronounced. There are several methods to handle this, such as skin grafting, flap surgery, or covering the area with artificial dermis. Each method has its advantages.
The parents expressed a preference for minimizing additional wounds on other parts of the baby's body and requested that all the webbed fingers be separated in a single surgery.
Our approach: We opted for artificial dermis induction without skin grafting, separating all four web spaces in one surgery and covering the area with artificial dermis.
Creating conditions for growth through functional training
One month after the surgery, the artificial dermis successfully induced the growth of the baby's own skin, and the artificial layer degraded and fell off. Once the wound healed, functional training became crucial. On one hand, functional training helps reduce the swelling in the baby's hand more quickly; on the other hand, it promotes the growth of the fingers.
7 months post-surgery
7 months post-surgery
After about a year of recovery, the baby's fingers showed significant growth in length and thickness compared to pre-surgery. This improvement can be attributed to both her natural growth and consistent functional training.
Her hand's appearance and function improved noticeably. The parents played a vital role in this process, persistently encouraging both passive and active functional training. Though the baby was initially reluctant to use the operated hand, the parents did an excellent job guiding her.
9 months post-surgery
9 months post-surgery
11 months post-surgery
Now, both the parents and I are satisfied with the results. We hope the family will continue functional training to help the baby achieve even better functionality and appearance over time.
11 months post-surgery