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Expert Care for Extra Fingers and Toes

Expert Care for Extra Fingers and Toes

by | Jul 25, 2023 | Hand Conditions

Published in Rite Up, 2023 – Issue 2. 

“Holden is very much the baby of the family,” says Ashley, his mother. “He likes being the center of attention and being constantly held. He’s also a little mischievous.” The youngest of three children, Holden, of Dallas, turned 1 in April and, according to Ashley, is into everything. “He’s in that ‘I now can get myself anywhere I want to be, so I’m going to explore anywhere I can’ phase,” she says. But, for the first nine months of his life, he could not wear a shoe on his left foot.

Holden was born with polydactyly, a condition in which a baby is born with extra digits. In Holden’s case, he had an extra pinkie finger on each hand and an extra toe on his left foot that sat on top of his other pinkie toe.

Ashley was prepared for the extra toe because her doctor had spotted it in her 20-week ultrasound. He said that they would have a pediatrician at her delivery who would put a clamp on it, and it would fall off like an umbilical cord. The two extra fingers were a surprise. “When Holden was born, the pediatrician said that given the number of extra digits and the way some of them were connected, they weren’t confident clamps would work,” Ashley says. Within 24 hours, they were referred to Scottish Rite for Children.

Hand surgeon Chris Stutz, M.D., evaluated Holden when he was just 3 weeks old. A leader in training hand surgeons from around the world, Scottish Rite was the first pediatric orthopedic facility in the nation to employ full-time hand surgeons. Dr. Stutz recommended surgery to remove the three extra digits at 9 months of age. The timing of surgery was scheduled late enough in Holden’s development to mitigate the risk of complication due to anesthesia and early enough to ensure that he could learn to walk.

“The idea of handing over your 9-month-old baby for surgery is terrifying,” Ashley says, “but it was so much easier knowing that he was with people who specialized in that.”

Holden came out of surgery with soft wraps on his hands and a hard cast on his foot. “As soon as the cast came off, we put him in a hard-soled shoe,” Ashley says. “His ability to stand and move around has been really great.”

“While this is a common procedure for our team, it is uncommon for the patient and family,” Dr. Stutz says. “We were happy to provide the comfort, confidence and expertise for this wonderful, sweet family.”

“We loved our Scottish Rite experience,” Ashley says, “and we’re glad that Holden can move on with being a 1-year-old who can wear shoes!”

Read the full issue.

Hand Camp Around the World

Hand Camp Around the World

by | Jun 28, 2023 | Hand Conditions

Scottish Rite for Children is world-renowned for its patient-centered care for children with orthopedic conditions, and our Center for Excellence in Hand is committed to caring for children with hand and upper limb conditions.

Focused on providing innovative treatment to help patients live active and independent lives, Occupational Therapist and Certified Hand Therapist Amy Lake, OTR, CHT, recently shared her knowledge at the 2023 World Symposium on Congenital Malformations of the Hand and Upper Limb. Working with a team from around the world, Lake served as co-chair. She shared her research and insight surrounding patient involvement in Hand Camp as well as the impact therapeutic camps have on children with hand differences. 

For more than 20 years, Scottish Rite has created a therapeutic and safe environment for patients with congenital hand differences through Hand Camp. Hand camp provides an opportunity for children with upper limb differences and their families to meet others facing the same challenges while enhancing confidence and self-esteem.

Lake’s research evaluates the positive benefits these camps provide to this patient population. Results showed that the participation in camp enhances their self-esteem and overall hand function, which promotes participation in extracurricular activities.

Her published study and passion for treating the whole child is inspiring hospitals all over the world to start their own hand camps. We are so proud to have Amy as part of our team sharing the incredible things happening at Scottish Rite.

Thumb Fracture Q&A

Thumb Fracture Q&A

by | Sep 23, 2022 | Hand Conditions

Thumb injuries are common, especially in young athletes, and can occur from direct hits, falls on outstretched hands or hyperextensions. We see them often in football, basketball, baseball and soccer.

Pediatric nurse practitioner Courtney Schneidau, P.A.-C., shares information about thumb fractures and how to handle these types of injuries in young athletes.

Anatomy of the thumb
The thumb is made up of two major bones — the distal phalanx and the proximal phalanx. The distal phalanx starts at the tip of the thumb, underneath the fingernail and extends to the knuckle. The proximal phalanx runs from the knuckle to the base of the thumb, where it connects to the hand. 
 
How do thumb fractures typically occur? 
A thumb fracture can occur anywhere in the thumb and is generally caused by a direct trauma, like from a fall or a hit to the hand. For example, if a player hits his hand/thumb on the helmet of another player while playing football.  
 
What are the main symptoms of a thumb fracture? How do you know if the injury needs medical attention? 
Symptoms can include: 
–    severe pain
–    swelling and tenderness
–    limited motion or inability to move the thumb
–    visible deformity or deformed appearance
–    a numb sensation or coldness in the thumb 

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You should seek medical attention if you are experiencing pain, bruising or swelling. It is important for a professional to examine the injury to determine the best course of treatment.

How is a thumb fracture diagnosed and treated?
Your provider will take a detailed history, including the activity that caused the injury, as well as perform a physical exam. X-rays of the hand and injured thumb will be performed to better evaluate the injury and rule out other injuries.

A fractured thumb can be treated through casting or the use of splints, which limit movement while the bones heal. Surgery is sometimes needed, depending on the location of the break. There are different techniques that are used to hold the bones in place, including the use of pins, plates or screws. Following surgery, a splint or cast is worn to ensure proper healing.

What is the outcome following a thumb fracture? 
Thumb fractures generally have good outcomes, following proper treatment and rehabilitation. Once the fracture has healed, hand therapy may be required to help restore motion.

Should you see a pediatric orthopedic specialist for a potential thumb fracture? 
Scottish Rite for Children treats children who need complex reconstruction following trauma or have hand disorders related to neurological conditions or nerve injuries. That includes fractures (shoulder to fingers), nerve injuries, tendon injuries and complex injuries. Our Sports Medicine team treats the comprehensive needs of athletes and provides management for sport-related injuries and conditions. Young and growing athletes are highly competitive and have unique conditions that require care by a pediatric team of experts. Learn more about our centers for excellence in Sports Medicine and Hand and how board-certified pediatricians, pediatric orthopedic surgeons, physical therapists, athletic trainers, psychologists and other specialists work side-by-side with each patient and their parents to develop the best game plan for treatment, rehabilitation and safe return to sport.

Learn more about our Facture Clinic.

Get to Know our Staff: Lindsey Ham, Therapy Services

Get to Know our Staff: Lindsey Ham, Therapy Services

by | Dec 13, 2021 | Therapy Services

What is your job title/your role at Scottish Rite for Children?  
I am an occupational therapist and certified hand therapist working primarily at the Frisco campus. 

What do you do on a daily basis or what sort of duties do you have at work? 
My primary role is an outpatient occupational therapist, specializing in pediatric hand conditions. While this sounds like a small subset, I assess and treat a wide range of diagnoses, including upper limb and hand differences, traumatic injuries and sport-related injuries involving hand, wrist, elbow and/or shoulder. In addition, I also see patients with cerebral palsy, arthrogryposis, arthritis and brachial plexus injuries. My job is to figure out what deficits are limiting their participation and independence with daily activities, such as dressing, bathing, toileting, school participation, sports and leisure participation and play. I then address these deficits through meaningful activities to get them back to doing what they love. Since we see all ages from newborn and up, every hour of my day looks different, ranging from playing a game of Connect 4 or Mancala to bear walks, push-ups and weight machines. We also fabricate custom orthoses (splints) for children who have fractures or surgeries that require immobilization.

What was your first job? What path did you take to get here or what led you to Scottish Rite? How long have you worked here?
My first job was as a certified nursing assistant at a hospital while I was in college. I always knew that I wanted to be in the medical field. My high school had an amazing health careers program where we were able to shadow many different jobs across the medical field. It was then that I was able to shadow an OT and fell in love with the career! I have been an OT for 13 years and at Scottish Rite for almost three years. I moved from Nashville to Dallas just to work at Scottish Rite, and it was one of the best decisions I’ve made! 

What do you enjoy most about Scottish Rite?
I love the atmosphere and team here! It is such a positive place to work. I love the collaborative approach to treat every patient. There is an open line of communication between therapists and physicians and that creates great outcomes for our patients. I love that everyone here has the same mission — to give kids back their childhood. 

Tell us something about your job that others might not already know. 
Your hand strength is important! This is something that I preach daily. People know to go to the gym and workout, but no one really focuses on hand strengthening. So, grab a stress ball and keep your hands strong! 

What was the best vacation you ever took and why?
I love traveling, so it is hard to pick just one. I would have to say my favorite was the cruise I took to the Bahamas last month because I got engaged!!  

Do you collect anything? How did you start?
Shoes and sunglasses — I guess not a true collection, but I have a lot of both! 

Do you play any sports or instruments?
I was a competitive cheerleader in high school and then coached through college. My sister owns a cheer and tumbling gym, so I am still surrounded by it. I also belong to a kickboxing gym and love it. 

Get to Know our Staff: Brittney Iagulli

Get to Know our Staff: Brittney Iagulli

by | Aug 4, 2020 | Hand Conditions

What is your role at Scottish Rite for Children? 
I am a nurse and work with the hand surgeons, both in Dallas and Frisco. My days are spent organizing and preparing their clinics, seeing patients with them and helping to provide an overall smooth patient experience. I work with patients on their post-operative routine and help educate them on how to care for their casts and wounds. I also coordinate referrals, make appointments, schedule surgeries and provide patient education prior to surgery. 
 
What do you enjoy most about Scottish Rite?
The sweet patients and all of my co-workers! Working here allows me to be both a mom and still feel like I am making a difference in this world by helping these kiddos.
 
What was your first job? Why did you decide to do the work you are doing now?
My first job was a cast/brace tech for an orthopedic practice in Ohio. That is where I met my husband and we moved to Dallas. I’ve always been an athlete and had interests in sports and orthopedics. My job as a cast tech gave me the experience to then become an orthopedic nurse. Plus, I just love kids! 
What’s the coolest or most interesting thing you’re working on right now?
I really like working with patients who have brachial plexus injuries or kids that have had to receive nerve grafts. I have seen Dr. Stutz do some amazing things and it is really cool to see nerve function return. 

What are you currently watching on Netflix/Hulu/TV/etc.? 
Ugly Delicious, Master of None, Outerbanks and The Dawn Wall. 

What would be the most amazing adventure to go on?
Right before COVID really hit, my husband and I went to Rwanda on a gorilla trekking trip. Hands down, it was the coolest thing I have ever done. I don’t think that my bucket list will ever end!

What are some small things that make your day better?
Hugs, kisses and giggles from my two babies.

What is special about the place you grew up?
GO BUCKEYES! OH-IO

What is your favorite thing to do when you’re not working? 
Travel the world or spend time at a lake or beach. We like anything with adventure or a body of water!