Neonatal polydactyly

Some newborns are born with deformed parts of their body, and polydactyly is a common deformity. Generally speaking, polydactyly refers to the fact that a newborn baby has six or more fingers on his hands instead of five. If polydactyly is not treated in time, it will cause the child's fingers to become deformed, and in severe cases it will even damage the normal function of the child's hands. So, when is the time for neonatal polydactyly?

1. Time of neonatal polydactyly

In the past, it was believed that the best time for surgery for complex polydactyly was between 4 and 6 years old before school. Children at this stage can cooperate, have clearer anatomical structures, and can also prevent them from developing psychological abnormalities. However, in Europe, America and Japan, it is currently believed that the earlier the correction of deformities is done, the better, starting about 6 months after birth. They believe that the period from 6 months to 3 years after birth is the period for establishing basic hand functions, and completing the surgery during this period can hopefully lead to perfect hand functions. For simple polydactyly, it is better to perform surgery 6 months after birth; for complex polydactyly with severe deformity and tissue defects, polydactyly resection, tissue transplantation or transposition, functional reconstruction and other surgeries should be performed after 1 year old, and regular follow-up should be performed until the development stops.

2. Causes of secondary deformity after surgery

Due to the wide variety of polydactyly types and the varying degrees of difficulty of the initial surgery, even very experienced physicians cannot guarantee a perfect surgical result. Moreover, some inexperienced physicians cannot correctly understand and deal with the abnormal anatomical structure of polydactyly and regard polydactyly resection as a very simple operation, resulting in a high incidence of secondary deformities after surgery.

1. The younger the age, the more difficult it is to identify the abnormal anatomy of the fingers, making it impossible to reconstruct the function during the initial surgery.

2. It is generally believed that the incidence of residual deformity is high in Wassel types II and IV. Some believe that after type IV thumb resection, 50% of patients need another surgery. Bony remnants at the base of the proximal phalanx are more common in type III.

3. Simple resection is an important cause of residual deformity. Interphalangeal joint instability is associated with failure to reconstruct the collateral ligaments at the time of initial surgery. The metacarpophalangeal joint instability was attributed to the failure to reconstruct the insertion of the abductor pollicis brevis muscle after radial polydactyly resection.

4. Polydactyly all involve anatomical abnormalities. Failure to correctly understand and deal with these abnormal anatomical structures will lead to instability and angular deformities of the metacarpophalangeal joints and interphalangeal joints after surgery due to persistent abnormal tendon dynamics.