Before surgery, this child had a Cleft hand deformity on the right hand. Although there were five metacarpal bones, the bones of two fingers were fused together, leaving the child with only four fingers.
Initial consultation
The parents were very anxious about their child's condition and had been searching for treatment options, but they hadn't found a suitable solution. After learning about our hospital, they eventually decided to travel all the way from Shandong to Wuhan with their child.
During the consultation, the parents had one major question: Could we turn four fingers into five?
The child's right hand already had relatively good finger function and mobility. If we forcibly separated the fingers to create five, both the appearance and function of the hand could be significantly compromised. The child's bone structure was also not suitable for creating a fifth finger. Even if the procedure were technically successful, it might not provide much real benefit.
Although creating five fingers wasn't a good option, we could surgically correct the sideways deviation of the index and ring fingers, bringing them into a more balanced and coordinated position. This would allow the child to grasp objects in a more natural position. Ultimately, this approach could offer much greater benefits.
Preoperative X-ray
Would simply removing part of the third metacarpal and stitching the area together work?
This was the mother's second question. I completely understand how much parents want to avoid putting their child through more extensive surgery.
However, in this case, simply stitching the area together would not solve the underlying problem. The fingers on the child's right hand would likely continue to deviate sideways.
The surgery needed to narrow the space between the second and fourth metacarpals. This would help reduce the sideways deviation, gradually bring the fingers toward the center, and improve the overall function of the right hand.
Once the parents understood the surgical plan, they felt much more reassured and decided to proceed with surgery as soon as possible.
Initial consultation
Six months after surgery, the parents brought their child back for the first follow-up visit.
As soon as the child entered the examination room, we could see a noticeable difference. We had been particularly concerned about the child's grasping movements after surgery. But thanks to the parents' excellent care and rehabilitation at home, the child was now able to grasp toys with ease during the examination.
More importantly, the child no longer relied on pinching objects between the second and third fingers as they had before surgery. This was a very meaningful improvement.
Before-and-after comparison of the right hand
With the thumb now participating in grasping, the child can practice many more hand movements. This should have little impact on future learning and work.
After correcting the finger deviation, the appearance of the right hand is also much more natural and balanced, without looking particularly unusual. With the parents' positive guidance, the child has also maintained a very healthy and positive attitude.
Six months after surgery
For a child with a congenital hand difference, hand function must always come first.
Surgery should never be performed simply for the sake of changing appearance. Instead, we need to find the best possible solution based on the child's existing anatomy and abilities-one that provides the greatest functional benefit and gives the child more opportunities to shape their own future with their hands!