Syndactyly



By now most people know Landon was born with his ring and middle fingers together to the tip and had surgery just before his 2nd birthday to have them separated.  

Warning!!   Some of these images can be graphic for people.  They aren’t bloody or anything just raw looking skin and stitches.


You can check out a bunch of pictures of Landon before the surgery Here on Facebook.

And Here is where I blogged about Landon’s actual surgery.

So what is this post about?  


Healing and recovery.



Just after surgery my little chicken looked like this:



For the first week we had this massive dressing.  As you can see, Landon was out being a kid within a day of his surgery.  Kids are awesome!  This isn’t to say he wasn’t in pain and he definitely wanted a lot more cuddles then normal.



But he adjusted to his new normal quite well. 



When we needed to do our own daily dressing changes it included aprox 10 minutes of soaking daily.  In comes the iPad to the rescue!!    The soak was two parts water to one part hydrogen peroxide.



His fingers were very swollen and pretty red along the zig zag incision line and skin graft area.  This one is a bit hard to see with all the water drips.  We would just shake his hand a little to get all the water off.



The most raw part was right down in the web where his skin graft was used {taken from the front inner hip}. He also had this bulb area around one knuckle and by his cuticles.  Landon is very pain tolerant so the dressing change did not bother him after the first two times when he didn’t like to look at it.  



The back view of his newly separated fingers.  His was called a complete simple syndactyly meaning his fingers were completely together to the tip and only affected his skin with no other soft tissue, nerve, cuticle, nails or bone involved.  It is a good kind of sydactyly to have if you have to have one.  :-)



We went to a whole hand covering for the 2nd week.   {No, he doesn’t always have an iPad.  I was taking pictures at the kids school and needed to keep him occupied.}



Do you ever reach that age where you think you don’t need extra clothes?  Yep, peed out so just wore a diaper.  Back to the hand..  He adjusted to his new dressing pretty well only pulling it off occasionally. 


We tried to go to an only finger dressing, but that came off super quickly every time.  After this we wrapped the fingers the most with a few wraps coming down over the palm and wrist to keep it all on.  Throughout this process we used a yellow gauze that was presoaked/covered in a petroleum jelly placed along the incision line then used white gauze to wrap the area and hand.  Over the gauze we either used tape or the stretchy stuff like they use when you give blood.  This was our favorite as it stayed well and went on easy.  It was pricier though.   The yellow guase kept his incision areas very moist for optimal healing.






We did get a bit of a scolding from the doc at our final appointment that we needed be putting lotion on his fingers each day to prevent the scars from getting to stiff and limiting his movement.   We have been doing this some.  Not as well as we should be.

Also, the doctor was in love with the good job he did and rightly so.  What a great doctor.  If you need any pediatric plastic surgery in the Raleigh Durham area definitely choose Doctor Jeffery Marcus.  He is wonderful.   As a word of warning, the first office visit will suck and be really late.  Just plan on it and you won’t be frustrated by a 2.5 hour wait and visit.



Saved by a friend while throwing feed to the ducks!  This kid used his hand with the bandages on and without as if his fingers were fine.



From the top it is already looking fab even back in late May just over a month post op.  The fingers are still pretty swollen here.



Then we also did a boo boo and didn’t put sunscreen on his hand when we went to Disney in May.  His fingers got a little sunburned.  Luckily it was minor and we learned our lesson.



Hi used his fingers independently as soon as those bandages came off.  He actually likes to stretch them apart quite often which is great for the healing process.  This means we don’t have to make him do it!!!



By the first of June the swelling is already down a lot.



This shot on the 4th of July shows how the scars are looking.  I’m very impressed.  As the overall redness went away we could clearly see the zig zag cut.  Each month the redness on the cut lines is getting less red.



Just a couple weeks after the top image his redness along the zig zag lines is even less.  The skin graft area in the web doesn’t show at all other then where the stitches were.



His fingers are also back to a normal size now at the 3 month post surgery mark.  YAY!



So from fingers that look like this just prior to surgery….  To 



Fingers that look like this in three months.   The road was not to bad even with a very active barely 2 year old who is definitely trying to exert his will whenever possible.   He is much more stubborn, opinionated and strong willed then the twins were combined!   This one and I will definitely have our battles as he grows and develops.  Yep Yep!!  But dang he is soooooo adorable and lovable.  It will all be worth it.   Wonder what he was thinking here?

Ariana - July 29, 2013 - 9:28 pm

I appreciate this post so much!! There is a lot of medical information on the web but I can’t seem to find any *personal* information from a parent’s view! Which is exactly what I really wanted!!
I’m glad you’re such a good photographer and have documented this whole part of Landon’s life! He’s going to love these pictures and memories captured in such a beautiful, detailed, and real way!

His fingers look fantastic. I can’t believe how well the scars look so shortly after surgery! It’s exciting to think of how much they’ll likely fade in the next few years! I wonder how faint they’ll be when he’s an adult!

~I have to add, though. As much as it’s a blessing and help to have fingers separated in such a wonderful way thanks to a talented surgeon, I think I’ll feel sad the day when I see my baby’s fingers after surgery for the firs time. Did you have any sad moments because his hand as it always was was now changed forever?

Shannon - July 30, 2013 - 4:16 pm

Thanks Ariana!
I’m so glad you commented and asked on the blog! It will be helpful for another mom searching for information on a child or baby recovering from a syndactyly surgery!!

That’s a good question on how his scar will fade in the future. My thoughts go back to when I was a kid. After being in a bad accident at the age of 4 where I needed plastic surgery to my face to put in a plastic cheekbone {mine had shattered}, I didn’t notice anything on my face until around the age of 8 or more. There was only a small scar in my eyebrow line by this time much like a chicken pox scar. By the time I was 18 the scar was completely gone. Hopefully, the scars from the syndactyly will be much the same. Kids are such amazing healers. Having said that, at the age of 9 months old I drowned. Yep, that too!! I still have an ankle scar like a 1/2 inch line like a divot in my skin from the big IV line they used.

Hmmm, sadness over his hand being changed? Not really, because I remember how frustrating it was to grab a pair of gloves and try to get them on his hand since we didn’t have any mittens. It is cool to think back to when he was born and I held him for the first time. My first thought was how he looked Exactly like my dad {weird!!}. My second thought almost immediately after noticing his hand then pointing it out to the paramedic who was there who thought it was pretty interesting too. I’m not one to count fingers and toes so it was strange for me to notice first!

There were quite a few people who suggested the surgery to separate his fingers was unnecessary. But really, I saw it as definitely necessary. He now has the option to do things like play an instrument, play baseball without a specially made glove, have more dexterity with his finger usage, wear gloves, wear rings {like a wedding ring!} and generally do finer motor tasks then if he did not have it done. Like you, we certainly never saw his fingers being together as a defect of any kind so it isn’t like he is ‘fixed’ now. There were just so many more benefits to having the surgery done then to let his fingers be. Also, since he is going to be one big dude and shows signs of being especially strong and balanced he might have the opportunity to be a pro athlete one of these days.

He had noticed his fingers together several times over the last year and tried to use his other fingers to get them apart. It was quite funny. He enjoys them apart now already which makes it all worth it.