I have a pair of small hands
One left to one right
Little hands, little hands
A total of ten fingers
……
Hey
Mom, how come I have two more fingers?
Preoperative illustration
Children with polydactyle (toe) deformity are not uncommon in the clinic, and what is rare is that both hands and feet are six fingers, that is, children have 2 more fingers and 2 toes than normal people.
A few days ago, Zhengzhou Renji Hospital admitted such a small patient Xinxin (pseudonym). He has been one year and two months old, has a pair of big eyes with bright spirits, and he also loves to laugh and attract people.
Careful observation revealed that Shin Shin's left hand, right hand, left foot, and right foot each had six fingers. As a mother, Ms. Zhang was particularly worried when she saw that the baby had such defects when the child was born, afraid of affecting the future work and life, because the child was too young to do any treatment, and now the baby is slowly growing, Ms. Zhang decided to take the child to the hospital for treatment.
Zhang Songjian, director of the fourth department of foreign medicine, and Director Huang Baogen received the small patients, according to the shape and position structure of Xinxinduosheng's fingers and the examination for comprehensive consideration, because he also had a small anesthesia time can not be too long, so the staging operation, first to solve the problem of bipedal multi-toes, and then solve the problem of multiple fingers of the hands. Shin Shin underwent a double little finger polydactyctomy under general anesthesia, and the operation went very smoothly.
Postoperative effects
Doctors remind that many parents now think that before going to school, the later the operation, the safer it is, and the risk of anesthesia is smaller. But the child's memory and the habit of using hands have been formed. Doctors recommend surgery at a specialized orthopedic hospital as early as possible within 2 years of age.
Polydactyle or polytones is the most common congenital malformation. Polydactyle is more common in the thumb and little finger, followed by the middle and ring fingers, rarely in the little finger, and some patients have a family history. The morphology and structure of the finger (toe) can be small fleshy, or it can be a finger with nails, bone, joints, tendons and neurovascular bundles that are nearly normal.
There are 2 reasons for the appearance of polydychi, one is genetic causes, if the elders in the family have symptoms of polydactyle, the probability of polydactys in the younger generation will be greater;
The other is environmental factors. If pregnant women are affected by environmental pollution and drug pollution during pregnancy, the prevalence of polydiskra will also increase.
For polydynystems there are mainly 7 types:
Type I polydactyle: the deformity is located at the edge of the plane of the interphalangeal joint at the distal end of the first metacarpal;
Type II polydactyle: the deformity is located in the plane of the interphalangeal joint at the distal end of the first metacarpal bone;
Type III polydactyle: the deformity is located in the plane of the interphalangeal joint proximal to the first metacarpal;
Type IV polydactyle: the deformity is located in the plane of the metacarpophalangeal joint;
V. polydactyle: polydactyles appear in the joint plane of the palm;
Type VI polydactyle: polydactyles appear in the surface of the wrist palmar joint;
Type VII polydactyle: all manifest as three thumbs.
An effective treatment for polydactyles is surgery.
In the treatment of polydystems, it is not only necessary to remove the excess phalanges, but also to perform osteotomy for bone deformities, adjust the joint capsule ligaments, and reconstruct the function of the flexed and extended fingers and the function of the palm.
Zhang Songjian, director of the Orthopedics and Functional Reconstruction Center of Zhengzhou Renji Hospital, answered the 4 questions that parents are most concerned about in detail
1. Will the anesthetics used in the operation affect your child?
Zhang Songjian: The current anesthesia technology and drugs are very advanced and will not affect the child's intelligence.
Zhengzhou Renji Hospital mainly uses "general anesthesia + ultrasound-guided brachial plexus block anesthesia" for the anesthesia of the child.
This anesthesia method reduces the amount of general anesthetics, ultrasound visualization technology can minimize the complications of nerve block, and postoperative analgesia is perfect.
General anesthesia plus nerve block has cut off the transmission route of pain to the brain, so general anesthesia only maintains a shallow anesthesia state in the child, greatly reducing the amount of general anesthesia, and the general anesthesia we use is short-acting, and the drug will be excreted with the child's breathing or liver and kidney metabolism. The child will wake up shortly after the operation, so parents do not have to worry too much.
2. When is it appropriate for your child to have surgery?
Zhang Songjian: The time of polydacty is determined according to the type of polydactyle of the baby, combined with the baby's physical condition.
If your baby's polydychild type is simple, surgery can be performed at 3-6 months.
If the type is complex and requires further reconstruction of hand function, surgery can be performed after half a year of age.
3. Will there be a recurrence after surgery?
Zhang Songjian: When I received the consultation, I also met many children who relapsed after surgery, and there were many manifestations of recurrence. Like what:
1. In the original polyphalange joints bulging pimples, some are retained normal fingers have been bent and deflected, etc., the reason for these problems may be that at that time in the treatment, the excess tissue was not completely removed, and the excess tissue with the growth of the child is also growing, it has become a bulging lump.
2. During the operation, only the excess tissue is simply removed, and the joints, tendons, etc. are not reconstructed, so that there will be curvature and deflection.
The occurrence of the above recurrence is caused by incomplete surgery, so parents must choose a formal professional hand and foot surgery and microsurgery hospital when choosing a hospital.
In addition, review is also a very important thing that many parents tend to ignore.
Because many finger is a congenital disease more often occurs in newborns, after treatment, the child continues to grow and develop, and the process of development will have many influencing factors, in order to achieve and maintain a good rehabilitation effect, prevent factors that are unfavorable for rehabilitation, avoid the occurrence of injuries, but also facilitate the doctor to grasp the recovery and development of the child in time, parents must pay attention to the review and regularly take the child to the hospital for review.
4. Will there be scars after surgery?
Zhang Songjian: In the treatment of polydychild in Zhengzhou Renji Hospital, the scars will be very faint and almost invisible. Because at the time of the operation, we started the prevention of scars, by using cosmetic stitches, which were stitched layer by layer according to the texture of the skin.
3 weeks after the operation, it will be recommended that parents give the child the application of scar removal drugs locally, and the early prevention and postoperative anti-scar treatment will make the child achieve good results
summary
The anesthetics used in the procedure are metabolized out of the body and do not affect development.
The duration of the operation should be determined according to the polydactyle type, and it is recommended to complete the operation before the age of 2 years.
Choosing a professional microsurgery hospital and actively reviewing can effectively reduce the chance of recurrence.
The cosmetic stitches taken by Zhengzhou Renji Hospital can reduce the occurrence of scars, and it will be better to cooperate with scar removal treatment after surgery.
(Liu Yanling)