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The Journey of ‘Hand Restoration’ for a Boy with Radial Bone and Thumb Hypoplasia Syndrome

The medical staff at FV Hospital could not help but feel emotional when seeing Minh Dat (7 years old, from Quang Nam) hold a pencil to draw and pour water to serve the doctors. The journey to help him regain full use of his hands was truly challenging.

Minh Dat’s right hand was clawed with an atrophied thumb (left image). After three surgeries, he is now able to grasp normally (right image).

Three reconstructive hand surgeries for a boy with a rare congenital deformity

Vu Hoang Lien, MD, MSc, Bone & Joint Centre at FV Hospital recalls that when examining Minh Dat in September 2022, the FV medical team noticed that his right hand lacked the radial bone in the forearm, and his thumb was atrophied meaning it was attached to the hand by a small piece of skin, with no function or movement. Minh Dat’s right hand could not extend straight. He was diagnosed with radial bone hypoplasia and thumb hypoplasia syndrome – a rare condition caused by genetic mutation.

Minh Dat was a bright and cheerful boy who seemed unafraid of hospitals and not shy around doctors. He and his family came to FV, hoping that the French “Hand surgery magician” –  Dr Stéphane Guero, could help him have a normal hand like his friends, The wish was to enable him to extend and grasp objects normally. The intense desire of the then 6-year-old boy helped him overcome the fear of pain and the operations to come.

Dr Stéphane Guero explained that to correct this deformity, it was necessary to align the child’s hand with the forearm axis, remove the atrophied thumb, and transfer the function of the index finger to create a new thumb, enabling the boy to grasp objects in the future. This is a complex surgery that very few surgeons can perform. Equally important was the close cooperation of the family to help Minh Dat extend his hand properly post-surgery.

Minh Dat dexterously uses his right hand after surgery

From September 2022 to the end of 2023, Dr Stéphane Guero and a team of doctors at FV Hospital performed three surgeries to reconstruct Minh Dat’s hand.

In the first surgery, a frame with a lock was placed on Minh Dat’s forearm and hand. The family was instructed on how to turn the lock twice a day, and later once a day, to gradually align the forearm with the hand. In the second surgery, Dr Stéphane Guero removed the frame, straightened the forearm bone, and inserted a long pin from the forearm to the hand to keep it from bending back again. In the third surgery, a digit transfer was performed. Dr Stéphane Guero moved the index finger to the position of the thumb.

The surgeries went smoothly. The brave boy endured the pain repeatedly, earning the admiration and affection of the FV medical staff. At a follow-up visit over a month ago, the doctors were overjoyed and moved to see that Minh Dat’s right hand could now grasp normally.

Dr Lien expressed “Since the final surgery in November 2023, Dat has been able to hold a pencil to draw and carry a cup of water to serve the doctors… performing all activities as usual. We are truly very happy and confident that he will have a bright future.”

A new life for a child with radial bone hypoplasia and thumb hypoplasia syndrome

Minh Dat is one of nearly 30 children who have undergone successful surgeries for radial bone hypoplasia and thumb hypoplasia syndrome at FV Hospital from 2010 to the present. These complex surgeries were all performed by Dr Stéphane Guero with the support of the orthopaedic trauma and hand surgery team at FV Hospital.

“The world-renowned “Hand surgery magician” – Dr Stéphane Guero explains about radial bone and thumb hypoplasia syndrome

Dr Stéphane Guero inormed us, that the rate of children born with thumb loss deformity is 1 in 5,000, while the rate of children born without both the radial bone and the thumb is 1 in 35,000. Some cases involve a small atrophied thumb that remains functional. In reconstructive hand surgery, especially thumb reconstruction, the selection of the new thumb and accurate identification of the vascular, nervous, and muscular systems for each finger is crucial. Surgeons meticulously calculate the optimal positioning of the chosen finger to serve as the new thumb, determine the length of the new thumb for shaping, ensuring both aesthetic appearance and functional integrity of the hand post-surgery.

Pham Nhat Huy (8 years old) is one of the cases who underwent finger transfer surgery and is now able to grasp normally.

“In terms of aesthetics, it’s essential to ensure that the surgery is carried out with great precision so that at first glance, one wouldn’t notice the absence of the index finger. The entire process takes about a year to complete, with the first three months dedicated to wrist immobilisation, followed by six months of radial bone and thumb reconstruction surgeries,” Dr Stéphane Guero explained.

To treat radial bone hypoplasia, a corrective bracing frame is needed.

It is known that currently, very few healthcare facilities in Vietnam perform hand deformity surgeries because besides expertise, it requires specialised equipment, such as corrective bracing frames. At FV Hospital, these frames are provided for children aged 1 and above to maximise support in postoperative radial bone correction.

Furthermore, FV Hospital benefits from the collaboration with Dr Stéphane Guero, one of the few experts worldwide capable of successfully treating complex hand deformities. These include finger relocation, restoring grasping function, separation of fused fingers, hand deformity reconstruction surgery, nerve disorder surgery, and bone grafting for congenital finger defects.

Every year, Dr Stéphane Guero arranges trips to Vietnam to perform surgeries for children with hand deformities. His surgeries have opened up new lifes by restored grasping function for hundreds of children with complex hand deformities allowing them to use their hands like other normal children. Many parents have tears of joy when witnessing their children write their first words with hands they thought had lost function.

Dr Stéphane Guero mentioned that he always chooses FV Hospital for these complex surgeries. Firstly, for its modern facilities and operating rooms meeting international JCI healthcare standards; secondly, for its experienced and professional medical staff, who are as enthusiastic and competent as those in French hospitals.
Vu Hoang Lien, MD, MSc stated that over the years, FV Hospital has sought connections with major medical centers and renowned experts worldwide to provide treatment and surgery opportunities for patients with rare congenital deformities in Vietnam, offering them a chance to change their lives. This also allows local doctors to learn, exchange experiences, and improve their expertise in treatment.

To schedule an appointment for consultation with Dr Stéphane Guero, please contact at: (028) 54 11 33 33

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