She is almost five years old. Other children around her can easily hold a pen to write and use chopsticks to eat, but she cannot. This is a young girl with abnormalities in the development of both thumbs. Her right hand has a triphalangeal thumb with polydactyly, while her left hand has a special type of thumb hypoplasia.
Previously, her family had taken her to many doctors, but most of the answers they received were "there's nothing we can do" or "wait until she grows older."
It wasn't until they found me online that they came from another city with a glimmer of hope. After meeting, the parents were very clear about their goal:
"We want to prioritize the right hand first-at least so she can write and eat in the future. As for the left hand, if the chances are not good, we don't want her to suffer too much more."
In fact, both hands can be improved through surgery. For the right hand, we can preserve and reconstruct the existing but underdeveloped thumb. This includes:
Removing the extra digit, Shortening the elongated metacarpal, Repositioning the thumb to widen the first web space, Stabilizing the joint.
With postoperative rehabilitation, both the appearance and function of the hand can be improved. The goals the parents hope for-holding a pen and using chopsticks-can be achieved.
For the left hand, there are two possible approaches:
1.Preservation approach: The surgery would be done in two stages. Aim to retain and improve the existing thumb. Advantage: preserves five digits .Limitation: improvement in appearance and function may be limited.
2.Index finger pollicization: Remove the current abnormal thumb. Transfer the well-functioning index finger and reconstruct it into a new thumb. Although the hand will have only four fingers, both function and appearance can be quite good.
We fully understand the parents' wish to prioritize the right hand. Therefore, our plan is to proceed step by step-right hand first, then left hand.
At present, we will focus all efforts on restoring function in her right hand and taking the most critical first step. Once the right hand has recovered well, we can then address the left hand.