This child has Poland syndrome, a rather unique deformity characterized by both short and syndactyly (webbed fingers) features, significantly impacting both appearance and function. At the age of 11 months, the child underwent surgery. During this follow-up at the age of 2 and a half, her hands had grown significantly larger and she could now grasp larger objects.
Initial Examination
My Recommendation: Perform surgery as early as possible
When the child first outpatient service, her hands couldn't open fully, couldn't grasp large objects, and there was a significant difference between her left and right hands. After assessing the situation, I advised the parents to consider surgery as early as possible.
Whether the hands can grow depends on two factors: first, their inherent growth potential, which refers to whether the length of the bones is normal;second, external stimuli after birth and self-initiated activities.The more activity and strength stimuli, the more they stimulate hand growth.Conversely, less activity and fewer strength stimuli result in slower hand growth.
Therefore, for such cases, we recommend providing a better foundation for strength training for the child as early as possible.
X-ray
One-time surgery to separate syndactyly
Before the parents brought the child to here, they had a certain understanding of her hand condition, so when I conducted a detailed analysis of the child's hand condition and informed the parents, they seemed less tense than before.
For this child's syndactyly, there are two surgical options: the first is multiple separations, which offer better blood circulation for the child but result in longer healing and recovery times, with inherent risks of circulatory disorders; the second is a one-time separation, which also carries the risk of circulatory disorders, but through specific techniques and measures, we can reduce this risk to a relatively controllable range while reducing the number of surgeries, allowing the child to engage in functional exercises earlier.
After hearing about both options, the parents agreed with the second option,hoping that we could separate the child's fingers in one operation.
Preoperative
Preoperative
Surgery created conditions for the child's movement
After more than a year of recovery, the changes in the child's hands were very noticeable. Some even asked if the child had undergone finger extension surgery, which wasn't the case; we simply deepened the webbing through surgery.
Additionally,because the child underwent surgery in the early stages of development, her finger range of motion increased, and she became more willing to use her hands.The more she moved, the more she stimulated hand growth,creating a positive cycle for the child.
reexamination
Successful postoperative functional exercises, credit to the mother
At any time, I always urge parents to guide their children in functional exercises because it's truly crucial!This is why I constantly emphasize to parents the principle of "Three parts surgery, seven parts care."
reexamination
This mother did an excellent job.Despite having to care for two children alone after the surgery and living far from the hospital, with the father being busy with work and unable to come for follow-ups regularly,the mother remained actively involved.From the photos and videos she sent, we often see the child playing with toys that require coordination between both hands.
As doctors, we can separate the fingers and create conditions for the child's movement. But it's the mother who truly makes the child move and helps the fingers grow, through her unwavering companionship and guidance.
We hope the little one continues to strive, and we anticipate even better hand appearance and function at the next follow-up!