Ectrodactyly: Treatment, Cost and Side Effects

Ectrodactyly is a birth defect in which the digits in the foot or hand i.e. toes and fingers are missing or have fused together. Usually the hands or foots have a claw like appearance with a deep cleft between the middle. The condition can appear from one limb to all four limbs .The condition where the digits are missing is called as Syndactyly and the condition where they fuse together is called Oligodactyly. There are many variations of Ectodactyly and each of this occurs due to mutation in a different gene. The most common type of Ectrodactyly is TYPE I SHFM (Split hand/foot malformation). Type I SHFM is caused by defects in the genes DLX6 or DLX5. Ectrodactyly is a hereditary condition that can occur by itself in certain cases as well as manifests along with other birth defects at times. In Some cases the condition of Ectrodactly is progressive in nature and the condition worsens as the finger keep fusing more and more over the course of time. This however happens very rarely. Not only does it cause difficulty in usage of hand and deforms the appearance, people having cleft hands also suffer from low self-confidence and low self-esteem as well.

Cleft hands/foots develop between 28th and 56th day of fetal development and can be identified during prenatal ultrasounds occasionally. Once the child is born the defects are visible. X – ray scans as well as other examinations are done to determine what all abnormalities are present in the bone, muscle and tissue structure of the hands or foots with Ectrodactyly. Based on these examinations the doctors may proceed with surgery if there is significant impairment in the functioning of the hand or in its appearance. In many case surgery may not be required at all if the person has very minimal amount of deformity that does not impact the functionality of the hand or foot much.

The Surgeries are invasive by nature, as they require a fair amount of incisions and modifications in the bone and tissues. Usually surgeries are performed as per the Manske and Halikis classification that tells the doctor about, which surgical techniques to apply based on the type of Ectrodactyly. Since the degree and type of abnormalities varies in each case, certain aspects of the surgery vary from person to person. That is why examination and diagnosis are a very crucial part of the treatment as well. The surgeries usually take three to four hours to perform after which they patient may be kept under observation for a few hours and then can be discharged.

In case Ectrodactyly is progressive in nature then you should immediately go for surgery. However if that is not the case then the surgery can be delayed till the child reaches an age of 1 to 2 years.

If the child has bleeding disorders or has complications related to general anesthesia , then you must consult a doctor first on wether to go for the surgery or not

Apart from the general side effects of surgeries like bleeding, infection, etc there are no other potential side effects of the surgery

Usually the instructions for post surgery care are given by the doctors themselves in case of Ectrodactly. In case they are not given, then you should prevent the child from using the hand too much during recovery. Additionally, you should feed the child a diet rich in calcium and vitamins so that the bones heal and muscles heal up faster. Once the child has recovered, you should encourage the child to do gentle activities like writing, picking things, etc. These activities should involve the use of the digits and thus helps in increasing their strength and flexibility.

In case Ectrodactyly is progressive in nature then you should immediately go for surgery. However if that is not the case then the surgery can be delayed till the child reaches an age of 1 to 2 years.

Treatment for Ectrodactyly usually falls in the range of Rs 70,000 – Rs 1,50,000

The results of the treatment are permanent in nature due to reconstruction of the hands and feets at bone as well as muscles and tissue leve

At present there are no alternative treatment for Ectrodactyly