Extra little fingers


The condition whereby a child is born with an additional little finger on one or both hands is very common. The condition is known as ulnar polydactyly.

Often it is inherited with a 50% chance of it happening. It can also occur spontaneously without anyone else in the family being affected.

Sometimes the extra finger is well formed but more commonly it has a narrow base or stalk and is therefore relatively floppy. Where the extra finger joins the hand can be a narrow soft stalk or in some cases can contain some bone. If the extra finger is on a narrow stalk there is a potential for it to twist, cut off its blood supply and turn blue/black.   In some cases this can be uncomfortable.  If the extra finger has a tendency to twist it is advisable to tape it onto the adjacent little finger.

How can the extra little finger be corrected?

Traditionally these extra little fingers were tied off after birth so the blood supply was cut off and the finger eventually turned black and fell off we do not advise this because it can be very painful and can lead to infection. We recommend that the extra little finger be removed through a short operation.

In children under three months it is possible to remove the extra finger if it is on a narrow stalk through a procedure which is carried out under local anaesthetic. Children at this age cope well with a small local anaesthetic procedure and find it no more upsetting than their usual immunisations. Sometimes if they are distracted with a little milk they sleep through the whole procedure. We would recommend correction under local anaesthetic as the safest method if your child has an extra digit which is on a narrow stalk. The consultation and removal of the extra finger can all be carried out at the same time as a one-stop clinic appointment.

If your child is older than three months or the extra finger has a more substantial connection to hand it is usually more advisable to wait until your child is over a year of age and have the surgery carried out under a general anaesthetic.

How do we prepare for the procedure?

You and your child will come to the hospital for an assessment with Mr Sivakumar. He will make sure that your child is fit and well and suitable for a local anaesthetic procedure. Once the consultation is complete your child will be able to have surgery in the same sitting. We would prefer your child to have fed beforehand if you are breastfeeding so that he is relatively sleepy during the procedure. However if you are able to express milk or bottlefeeding it would be preferable if he/she were a little hungry so that we could give him or her feed during the procedure to distract them.

What does the surgery involve?

Once the local anaesthetic has been administered Mr Sivakumar will gently remove the extra finger. He will then make sure the area is clean and dry and suture the wound with a dissolvable stitch. A very small dressing will be used to cover the wound. The procedure takes approximately 30 minutes.

What after-care is involved?

Pain relief

The local anaesthetic will work for a few hours after the procedure to ensure that your child continues to be comfortable. We will provide you with information as to when to start simple oral painkillers such as paracetamol syrup. Most children only need a dose on the evening of the surgery.

Dressing care

It is important to keep the operation site dry and covered for approximately five days. If the operation site becomes wet please gently dry and apply a sticking plaster. After 5 to 7 days the dressing can be removed. This can be done in a further consultation or by your family doctor’s dressings nurse. All the stitches used are dissolvable and they will begin to fray away after approximately two weeks.

Complications

The risk of complications from this type of procedure is very low. If your child shows any signs of infection such as redness or high temperature it is important to contact us or your family doctor.

What if my child has an extra digit on the thumb side?

If your child has a similar condition but the extra digit is on the thumb side of their hand it is not usually possible to remove it under local anaesthetic. It is however still important for you to have a consultation to determine the best way to have the extra thumb removed