Yikes ― My baby has an extra finger!

What can you do if your little one is born with an extra finger or toe? We detail the treatments.

An expectant mother’s 20-week detailed scan is an exciting but nerve-wracking experience. Many parents-to-be anxiously wait as their sonographer counts their baby’s digits on the ultrasound

But what does it mean if your baby has more than the usual number of fingers or toes? Polydactyly ― derived from the words “poly” meaning many, and “dactyl” referring to digits ― refers to the condition where a person has extra digits on his or her hands and feet.         

Several well-known people around the world are known to have this condition. American actor/comedian Drew Carey reportedly has six toes on his right foot. American blues guitarist Hound Dog Taylor, who was born with extra digits on both hands, only removed the extra finger on his right hand at age 41.

What is even more extraordinary is that the members of one Brazilian family of 14 each have six fingers on each hand, and six toes on each foot. Known as The Family of Six, the De Silva family from Brasília say their abnormality makes them “stand out from the crowd” and is an asset as it make them better musicians and competitive goalkeepers.

“It’s usually detected at birth, but may also be seen in ultrasound scans… It can range from skin tags, to floating digits, to even completely formed digits.”

Hand surgeon Dr Tan Ter Chyan of Hand Surgery Associates notes that polydactyly occurs on average in 1.7 out of 1,000 live births. The incidence is higher in some cultures ― for instance, it is four to 12 out of 1,000 live births among Africans.

Polydactyly, a genetic condition that can run in families, usually doesn’t have any health effects on the child.

“It’s usually detected at birth, but may also be seen in ultrasound scans,” Dr Tan says. “It can range from skin tags, to floating digits, to even completely formed digits.”

The extra digit could just be an extra nub of skin, or it may connect to the hand or foot with a small stalk of tissue. Some completely formed digits may have all the normal tissues such as bone, muscles and nerves.

An extra finger is most commonly seen on the thumb side and less commonly seen on the little finger side, Dr Tan notes. In other situations, the extra digit may be found between other fingers and toes (central polydactyly).

 

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Treatment options

So, what are the treatment options if a baby is born with polydactyly?

In some cultures, removing the “lucky digit” is frowned upon, Dr Tan says. But in most Asian or Western cultures, he adds that “conformity is usually favoured and families would want to have the extra digits removed”. Other practical concerns ― like removing the extra toe so that shoes fit better ― are also factored in.

The method for removing the extra digit depends on how it connects to the hand or foot. An extra digit may connect with only a narrow stalk of tissue, or it may share bones, muscles and other tissues with the limb, so that the connection is deeper.

The ideal time to perform this surgery is when the child is between 9 months and 2 years old. The anaesthetic risk is lower after 9 months, the side effects are few, including infection of the wound.”

If there isn’t a skeletal connection, the doctor can simply tie off the extra digit, which stops the blood flow to the digit such that it will fall off. Just like the stump of the umbilical cord falling off soon after birth, the extra digit should fall off within two weeks.

A more complex procedure is needed if it involves bone, ligament and tendon. The surgery may involve carefully cutting through or around the bones, muscles, ligaments and tendons, and some tissues may need to be moved or reconnected. Occupational therapy may also be necessary to help with any scarring and swelling.

The ideal time to perform this surgery is when the child is between 9 months and 2 years old. Dr Tan explains, “The anaesthetic risk is lower after 9 months, the side effects are few, including infection of the wound.”

He adds that the procedure should be performed early enough ― “before the child develops fine hand function, pen grip, and so on”. If the child has surgery after the development of these functions, they may need to relearn some of these fine motor skills.

Photos: iStock

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