Your child has been diagnosed with small (pinky) finger duplication (postaxial polydactyly) and recommended surgery. The information on this page describes the two surgical options for removing an extra small finger, the risks of the procedure, and how to take care of your child at home after the surgery.
Surgery
There are two surgical options for removing an extra small finger, depending on your child’s age and whether the small finger is connected by a thin skin stalk or a bony connection.
Surgical removal in the plastic surgery clinic
Your child may undergo removal in the plastic surgery clinic if their extra small finger is connected by a loose skin stalk and they are either under three months or above 10 years of age. The procedure will be performed under local anesthetic in clinic, meaning your child will be awake for the procedure. Your child’s finger will be numb from the anesthetic. You will be with your child the entire time unless your preference is to be outside of the room.
If your child is under three months of age, bottle or breastfeeding during the procedure is encouraged to allow the optimal experience for your baby. You should time your baby’s feeds so that they are due to feed when the procedure starts.
The procedure will take approximately 30-45 minutes to remove one extra digit, and 60 minutes to remove two extra digits. Dissolving stitches will be used to close the skin and surgical glue will help to protect the incision as it is healing.
Note: If your child is between three months of age and 10 years of age, they must have their procedure done in the operating room (see information below).
Surgery in the operating room
If your child’s extra small finger is connected by a bony stalk, they will undergo removal in the operating room. Children must be at least one year of age before being able to have surgery. Children having surgery in the operating room require general anesthesia. Your child’s extra finger will also receive local anesthesia in the operating room. Surgery in the operating room takes about one hour. Dissolving stitches will be used to close the skin and surgical glue will help to protect the incision as it is healing. A small dressing may also be applied, depending on your child’s age and activity level.
After the procedure
If surgery is completed in the plastic surgery clinic, your child may go home after their procedure is completed.
If surgery is completed in the operating room, your child will go to the recovery room for about one to two hours. Once your child is eating and drinking well and their pain is under control, they may go home.
Risks and complications of surgery
- As with all surgeries, there is a risk of infection. This risk is low and would be treated with antibiotics.
- There is a low risk of nerve injury, which can cause numbness to the main small finger. Numbness usually resolves over time.
- Your child will have a scar on the small finger after surgery; however, the scar generally heals well.
- It is possible for your child to develop a sensitive scar later in childhood or adolescence.
Caring for your child after the procedure
Skin care
For surgery completed in the plastic surgery clinic, the small finger will be covered with surgical glue. Your child may resume regular bathing with soap and water after the procedure. Please avoid applying lotion or cream to the site, as these can cause the surgical glue to break down.
For surgery completed in the operating room, the small finger will be covered with surgical glue, and your child's hand will be covered with a bandage for approximately five days. It is important to keep the bandage clean and dry. To bathe your child, sponge baths work well.
The surgical glue will flake off gradually within the first one to two weeks after the procedure. Usually, the stitches will be fully dissolved, and the incision will be fully healed two to three weeks after the procedure.
Pain
To control pain after surgery, you may give your child acetaminophen and ibuprofen as needed.
Activity
Restrict strenuous activity for the first few weeks after surgery.
Follow-up
After surgery, you will be contacted via telephone or a virtual call to discuss how your child is healing. It is normal for the scar to be slightly thick and bumpy initially. Scar massage is used to improve the appearance of surgical scars. See Scar massage for surgical scars for more information.