This little one is full of energy, and as soon as you touch his little hand, he moves non-stop. At that time, he was almost 7 months old and weighed a healthy 19 kilograms. The parents came all the way from Anhui province to see me, hoping to have the surgery for their child's left hand polydactyly as soon as possible.
Preoperative
The child has a type IV polydactyly deformity in the left hand. The parents noticed the uniqueness of the child's fingers right after birth. After researching online about polydactyly, they immediately contacted me and rushed from Anhui to Wuhan within a few days.
When can the surgery be performed for a baby with polydactyly?
During the first outpatient visit at 6 months of age, the parents were a little anxious, afraid of missing the optimal surgical time for their child. However, there is no need to worry.
Generally, polydactyly surgery can be performed after the child reaches 6 kilograms in weight and has no heart or respiratory diseases. The recommendation for early surgery is mainly based on considerations for the child's recovery and psychological development.
Preoperative
Young children have strong recovery abilities, but the older they get, the slower the recovery becomes, especially in cases of crab claw polydactyly, where adult surgeries are far more complex and slower to recover from compared to surgeries for children.
Additionally, around 6 months of age, children have less self-awareness and perceive pain differently from adults. After the surgery, they have a relatively limited depth of psychological memory. Therefore, if conditions allow, it is better to perform the surgery as early as possible for the child.
Why couldn't the surgery be performed despite the parents' request?
During the outpatient visit, the child had a slight cold, and the parents mentioned that the child had a runny nose for a few days.
In such cases, parents should be cautious as surgery cannot be immediately performed when the child has a cold or fever.
When a child has a cold or fever, their immune system is compromised, making surgery inadvisable. Additionally, if the child has cough or phlegm in the throat, it can also affect anesthesia during the surgery, increasing the risks.
For the child's safety, the surgery must be scheduled at least two weeks after the child has completely recovered from the cold, following a thorough physical examination to ensure everything is in order.
After six months post-surgery, the mother brought the baby for a follow-up examination.
The little one is still very active, and his hand moves vigorously as soon as you touch it. He tightly grasps my hand, indicating that the removal of the extra fingers has improved his five-finger strength, coordination, and grip without any issues.
The parents mentioned that they had stopped using orthotic devices, but I still recommended that they continue using them to prevent finger deviation.
Postoperative follow-up
Since the child's recovery is going well, it is important to maintain this state. Orthotic devices are not meant to restrict the child but to provide a stable recovery environment. Therefore, I advised the parents to continue using the orthotic devices at night after guiding the child through functional exercises during the day.
This reduces the probability of scar contracture. Along with daytime functional exercises, I believe the child's left hand functionality will have a good recovery!