more-in The minute Rashmi (name changed) saw the hand of her newborn baby Ayushi (name changed), her heart sank. Ayushi had an underdeveloped thumb in the right hand, which meant she would struggle with chores as basic as holding a pencil, fastening a button, tying the shoelace, etc. She suffered from a rare condition called radial club hand with hypoplastic thumb that affects about one in every one lakh births. Ayushi’s parents were worried about her future. A few months down the line, Ayushi tried to pick up objects using her index and middle fingers as she could not use her thumb at all. She faced extreme difficulty in performing tasks that other children performed with ease. Though people can survive without thumbs, they are unable to perform day-to-day activities easily and attract humiliating comments from others. PSRI Institute of Orthopaedics chairperson P.P. Kotwal gave a ray of hope to the parents, who did not want their daughter to suffer. “We decided to reconstruct the thumb from Ayushi’s index finger using a procedure called as pollicisation. The four-hour-long surgery involved rotating Ayushi’s index finger, shortening it, placing it where the thumb would normally be, and restoring the finger’s blood vessels and nerves,” said Dr. Kotwal. He said the doctors had to ensure that the recreated thumb developed normally so that Ayushi would not be stuck with a baby-sized thumb. The new thumb — reconstructed from the index finger — looks like a thumb and also functions like one. ‘Challenging operation’ “It is an incredibly challenging operation. It is one of the most complex surgeries I do because a child’s hand is very small. Structures like the blood vessels, nerves, etc., are minuscule,” he said. “This surgery gives best results in terms of function if it is done when the patient is between one-year-old and 1.5-year-old. At this age, the adaptability of the brain to the newly reconstructed thumb is optimum. If an adult were to undergo the same procedure, he/ she would have a hard time learning how to use the new thumb because the mature brain does not have the same adaptability”. The surgery has left Ayushi with one thumb and three fingers but many a times people do not notice that one finger is missing. Moreover, the thumb is a very important digit that is essentially required in almost every function of the hand. In these children, the goal is to provide them a functional hand.

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