The medical fraternity of India could take pride in the Pune doctors who improved the hand mobility of a three year old girl using surgery. The girl, from Iraq was born without thumbs. Living with four fingers in both hands, she had only limited ability to hold objects.

The procedure was done at the Inamdar Hospital in Pune on March 9. In the procedure, a team of doctors wielded pollicisation- the surgery technique by which an existing finger is made functional like a thumb.

The plaster was taken off twenty one days after the surgery. The girl- Zahraa Hussein Abdali Badrah could now not just pick up objects but also scribble easily.

The girl’s father died from an illness when she was just nine months old. Her family hails from the Iraqi city of Najaf. For the surgery, she was accompanied to India by her mother and uncle.

The girl’s mother, Kaherah Jaber Al Aaameri said, “Life for my child will be easier after the surgery.”

“Doctors suggested that she play with a squeeze ball regularly to improve her hand movement,” said Yaareb Jabbar Salman Al Aaameri, the girl’s uncle who runs a confectionery business back in Iraq.

A complex procedure

The procedure on Zaahra took 2.5 hours to finish. “The thumb is the most essential finger, allowing us to write and hold objects easily. During the surgery, we made incisions to create a webbed space and altered the size and plane of the index finger, making it functional as a thumb. It is an intricate process, as it is important to ensure that muscles and tendons aren’t damaged. Magnification was used to identify and understand structures, so as to best retain sensitivity and maintain mobility,” Dr Sumit Saxena, the hospital’s consultant plastic surgeon said to a newspaper.

The girl’s brachial plexus was injured. This has brought down the strength and mobility of her left hand. The girl also suffered from radial deviation- her wrist and hand were not set straight.

Invite to India when faced with an uncertain future

Dr Murtaza Adeeb, senior orthepaedic surgeon at the hospital had met the girl’s family when she visited Iraq on a professional capacity in February.

Many doctors in Iraq were unable to provide the family with a definitive answer about the girl’s future. Dr. Adeeb then recommended a trip to Pune for the procedures. “The index finger on her right hand was rotated to make it function as a thumb, as there is very little one can do without thumbs. Pollicisation couldn’t be done on her left hand as there is a possible injury to her brachial plexus,”he said.

The procedure, though not rare is complex.  “I have personally seen three such cases in the last eight years,” said Dr Saxena.  According to Dr Sameer Desai, a Pune based paediatric orthopaedic surgeon, on average, he sees one or two kids with a similar case each year. He said that a general orthopaedic might come across one such case every five years. “The absence of thumbs highly limits mobility, and this afflicts maybe 0.1 per cent of a population of 1,000. Pollicisation is a complex procedure, as it is important to maintain functionality and utility of the finger while ensuring that blood vessels are intact and no damage is caused,” he said.

According to Dr Anil Bhatia, consultant hand surgeon at the Deenanath Mangeshkar Hospital, he comes across some 10 to 15 such cases every year. “The pattern of pollicisation surgeries hasn’t changed much in the last 55 years, as no other better procedure has been found,” he said.

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