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At Boston Children’s Hospital, our orthopedic and plastic surgery teams know that you’re concerned about your baby’s hand difference. It might ease your mind to know that we’ve developed innovative surgical treatments for children with all variations of thumb duplication. Learning more about this condition may help you feel more confident and informed as we work towards healing your child.
Thumb duplication is a form of polydactyly (an extra digit in the hand or foot) in which your child’s hand (usually just one side) has more than one thumb.
Yes, although almost all forms of thumb duplication require complex surgical correction and hand reconstruction.
• The extra thumb can occur at the joint of the outermost bone (distal phalanx).
• The closer to the hand that the extra thumb occurs, the more complex the congenital difference is—such as bent or
angular deformities, stiffness, limited range of motion and underdevelopment.
Yes, Asians, Caucasians and Native Americans are more likely to have an extra thumb, while African-American children are more likely to have an extra little (pinkie) finger.
During normal development while the baby is still in the womb, the hand initially forms in the shape of a paddle. At about the sixth or seventh week of pregnancy, this “paddle” splits into separate fingers. Various forms of polydactyly—including thumb duplication—result if there’s an irregularity in this process: An extra digit forms when a single digit splits in two.
The vast majority of the time, this occurs sporadically, meaning that the condition happens without an apparent cause. But some may be due to a genetic defect or an underlying hereditary syndrome, especially if your child’s thumb has three bones instead of two. Caucasians, Asians and Native-Americans are more likely to inherit the condition than African-Americans.
Thumb duplication is one of the more common congenital hand conditions, affecting about one out of every 1,000 babies. Usually, only one of a child’s thumbs is affected.
No, an extra thumb isn’t usually painful.
An extra thumb can often be seen by ultrasound prenatally, and by eye at birth. Your doctor will use x-rays to assess the underlying structure of your baby’s finger and determine a course of treatment.
During normal prenatal development (while the baby is in the womb), the hand initially forms in the shape of a paddle, and then eventually—in about the sixth or seventh week of gestation—splits into separate fingers. Thumb duplication and other forms of polydactyly result if there’s an irregularity in this process: An extra digit forms when a single digit splits in two.
The vast majority of the time, this occurs sporadically, meaning that the condition happens without an apparent cause. Some may result from a genetic defect or underlying hereditary syndrome, particularly if your child has a thumb with three bones instead of two. Caucasians, Asians and Native-Americans are more likely to inherit the condition than African-Americans.
Your child’s doctor will know by sight that your baby’s hand has an extra thumb. The doctor will refer you to a hand specialist, who will guide you to a more detailed diagnosis and treatment plan.
If your child is diagnosed with thumb duplication, you may feel stressed and lose track of the questions that occur to you. Lots of parents find it helpful to jot down questions as they arise—that way, when you talk to your child’s doctors, you can be sure that all of your concerns are addressed.
Some of the questions you may want to ask include:
• What is happening to my child, and why?
• What will x-rays reveal?
• What actions might you take after you review my child’s x-rays?
• Is surgery necessary? Are there alternative therapies?
• Will my child be OK after surgery?
• Will there be restrictions on his activities or capabilities?
• What will be the long-term effects?
• What can we do at home?
It’s natural for parents whose babies are born with an extra thumb to feel concern. Depending on the extent of your child’s condition, his treatment and recovery may be fairly straightforward, or may require more than one surgery.
Even though you understand the importance of surgery and therapy for your child, you still might experience his treatment and recovery as a stressful time. If you feel frustrated or depressed, speak to your doctor or counselor to get help. Professionals in Boston Children’s Center for Families can provide you with important resources and referrals.
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”