Untreated Adult Hypoplastic (Small) Thumb
On occasion, an adult comes to my clinic for evaluation of one issue and a previously unrecognized issue is identified. This type of presentation can come in different varieties and, due to my...
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Activity Specific Prosthetics
This is a brief post on activity- specific prosthetics. There has been much controversy on the timing and appropriate use of prosthetics in kids. I have previously blogged about this several times as...
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Nerve Injury after Trauma
The blog is mostly about kids born with differences in the arms (and occasionally legs). However, my practice also includes kids with sports injuries and other traumas. I will occasionally post...
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Hand Camp 2019- St. Louis Shriners Hospital
I realize that I post about Hand Camp nearly every year. Our St. Louis Shriners Hand Camp is really something special. But I do so for good reason- it is just so impactful for kids, families, staff,...
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Not the typical hand deficiency- ulnar cleft hand
A patient with a thumb and three normal fingers has a hand that functions at a near normal level and looks great. The narrow hand caused by a lack of a single finger (as long as the others are well...
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Ulnar cleft hand, part II
My most recent post, from Dec 5th, was on a rare type of cleft hand, the ulnar cleft hand. Ulnar cleft hand is very different and even less common that the classic cleft hand which involves the...
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Amniotic Constriction Band- how we can help function.
Amniotic constriction band is a common condition which typically involves more than one extremity. While the belly and face can be involved in rare patients, the arms and legs are the classic sites....
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Cleft Hand: Beyond the Basics
I have posted numerous times on cleft hand. (See other posts.) In my world, this is a still an unusual diagnosis and can be challenging as each child is somewhat different than the next. The early...
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Recurrent Syndactyly
Syndactyly is the abnormal connection between fingers- typically skin connection but sometimes bony connection (called complex). I have written much about it HERE. There is also information on the...
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Two different thumb birth differences
The thumb is our most important digit. In the adult, we estimate that it affects about 40% of hand function. So, a thumb that is not fully or normally developed may really affect our abilities-...
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Syndactyly: The Type Matters.
Syndactyly, simply put, means joined fingers. However, there are a number of different types including:- cutaneous (or simple)- only a skin connection- Complex- with a bony connection- Complicated-...
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Radial Deficiency Outcome
Radial deficiency (or radial longitudinal deficiency, RLD) is one of the most challenging conditions that I treat. We classify patients with RLD based on their bone development but that does not...
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Congenital Differences- Timing of Intervention in the era of COVID-19
March 28, 2020We are in an unprecedented time. COVID-19, the coronavirus which began in Wuhan Province in China in late 2019, has impacted our world in many ways. Medical centers in the US and Europe...
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The Elbow in Birth Differences of the Upper Extremity
The elbow is not commonly discussed around the topic of birth differences of the upper extremity. We discuss fingers, wrist, and forearm most commonly. The shoulder is also occasionally involved but...
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Radial polydactyly- progress and patient follow up
I have shared my thoughts on radial polydactyly (extra thumb) a number of times- those other posts can be found at https://bit.ly/3emosGU. Radial polydactyly is a common diagnosis for those children...
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Pollicization Long Term
Hello all. I want to share a good result in a challenging pollicization procedure. This patient has radial longitudinal deficiency with a poor, very limited thumb (we call it type 4 hypoplastic...
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Tight First Webspace
The space between the thumb and index (pointer) finger is crucial for function. We say that the thumb accounts for 40% of hand function - much of that function is related to grasping large objects in...
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Syndactyly as part of a syndrome
Syndactyly is most commonly an isolated finding which we believe is "simply" related to a failure of the cells to regress during development. This failure to regress means that the webspace does not...
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Early Action in Madelungs Deformity
Years ago, I met an 7 year young lady who came to my office with no complaints. Mom brought her even though she had no hand or wrist pain and no functional limitations. The reason for the visit was a...
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An Unusual Pollicization Procedure
Radial polydactlyly (extra thumb) is a relatively common problem for those of us who treat kids with birth differences/ anomalies of the upper extremity. Please see the following link for previous...
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2 Common Types of an Uncommon Condition- Symbrachydactyly
When I consider all of the different patients with a birth anomalies that I have the privilege to evaluate and treat, there is no question that symbrachydactyly is the diagnosis most often misnamed or...
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2 Reasons for Less than 5 Fingers
A brief post with lots of pictures and videos on two conditions that may cause less than five fingers. As I have previously written, there are 5 common causes. Parents have given...
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Forearm Synostosis- Facts and My Approach to Treatment
I have previously blogged about forearm synostosis HERE. A few important points1) It uncommon compared to other upper extremity anomalies but is perhaps the most common of the forearm birth...
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Understanding the 'Why' of Upper Extremity Birth Differences Part 1
Birth differences of the upper extremity have many different forms/ presentations. These can be a dramatic with a shortened or deviated extremity or very subtle/ mild with slightly short fingers or a...
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Syndactyly, Macrodactyly, and Keloid
The treatment of syndactyly is highly successful, no matter the preferred technique. That is the classic technique of Flatt (dorsal commissure flap and zig- zag incisions- ) or graftless techninques or...
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