This is a baby with Poland syndrome. The features of the hand are very distinct - short fingers with syndactyly (webbing). As we can see, on the left hand, except for the relatively open space between the thumb and index finger, the index and middle fingers, middle and ring fingers, and ring and little fingers are all fused. The webbing is relatively high, and the fingers are short.
At that time, we used an artificial dermis–induced skin regeneration technique to avoid skin grafting and separated all the fused fingers in a single surgery. Now, the scars on the little hand are very shallow, and the hand functions quite well.
22 Months Post-Surgery
Before surgery: The child's left hand was "restricted," and the parents had 3 main concerns
1. Could all the fingers be separated in one surgery?
2. Would skin grafting be necessary?
3. After separation, would the fingers be able to grow properly?
As soon as they entered the consultation room, they asked me directly. When I told them it was possible to separate all the fingers in a single surgery, they first looked happy, then hesitated slightly, and carefully voiced their concern:
"We had asked another doctor before, and they said it would take two surgeries. They were worried that if we did it all at once, the fingers might become necrotic, and the child might lose a finger."
First Consultation
This type of risk does exist, as the parents mentioned. It's related to the surgical technique - mainly the cutting and stitching. But in our experience, the risk isn't significantly higher. Whether separating two or three fingers in one surgery, the standard risks like infection or bleeding are similar. Completing the separation in one procedure does not significantly increase these risks.
After hearing my explanation, the parents nodded repeatedly and said: "We also want to get it all done at once and don't want our child to suffer twice."
Having treated so many patients, we deeply understand what parents are thinking. A single surgery not only reduces the child's suffering but also allows for earlier functional rehabilitation. For the parents, it saves time, energy, and money. So whenever we can solve the problem in one operation, we try our best to do so.
Before Surgery
Next, "Will skin grafting be needed during surgery?"This is a very common question from parents. They worry because skin grafting means taking skin from another part of the child's body, leaving scars and possibly leading to necrosis or pigmentation issues.
We generally use an **artificial dermis-induced method to avoid skin grafting**. This means that the skin defects left after finger separation are covered with artificial dermis. Think of it like scaffolding used when building a house - once the house is finished, the scaffolding is removed. Similarly, once the child's new skin grows in, the artificial dermis naturally falls off. The wound heals with new skin, without survival or pigmentation issues. However, compared to skin grafting, this method takes longer to heal, requiring parents to devote more time and effort to care.
Initial Consultation
As for whether the fingers will grow after separation - I believe this depends largely on the child and the parents. Functional exercises after surgery are essential. The appearance of the hand also improves with active use and stimulation. Based on our experience, if post-op rehabilitation is done well, both function and appearance will greatly improve.
After discussing it all, we proceeded with our plan - using artificial dermis to avoid skin grafting and successfully separated all the fingers.
Preoperative X-ray
After Surgery: With strict adherence to medical advice, the hand has gotten better and better!
The first stage after surgery was wound care. Following our guidance, the parents first learned how our doctors did the dressing changes, then did it themselves at home, and later came back to Wuhan for a while. With their careful care, the wounds healed in just over a month.
Once the wound healed, the second critical phase began: functional training. Since the left hand had undergone surgery and the right hand hadn't, the child naturally preferred using the right hand. But the parents did a great job at this stage - buying lots of toys that required both hands, encouraging the child to twist, grip, and grasp, constantly demonstrating and gently guiding the child to use both hands.
2 Months Post-Surgery
Now it has been 22 months since the surgery. We can clearly see that the operated hand has grown longer and thicker - and not just in proportion. Its function is excellent, showing both strength and precision in fine motor skills.
Seeing the child's current condition, the parents are very satisfied - it has met their expectations. I believe that with continued training, the child's hand will not pose any major limitations in daily life, schooling, future work, or even sports.
22 Months Post-Surgery