Toe to Finger Transfer, One Year

Hard to believe that last year was the summer of the casts for Zeke.  Last year, at the end of May, Zeke underwent a toe to finger transfer that removed his second toe and used that toe to create a third finger.  It was a very long surgery.  We arrived at the hospital at 6:40 and Zeke finally made it back to his PICU room around 7:45.  The actual surgery went from about 10 to 7.  (Read here and here for more details.)  Because they wanted to give the blood vessels time to heal undisturbed, Zeke had to be intubated overnight.  That was probably the scariest part of the whole surgery:  sending him off for such a long surgery and then having him return with a tube down his throat and not really conscious until the next morning.

As to the results, one year out, the scar tissue has dramatically reduced in thickness.  He still has a lump of tissue next to the new finger which as of right now, will stay there.  That section of his hand was very vascular so at the time of surgery, Dr. Moran did not want to mess too much with it since there was already so much vascular work being done.  It may also change over time, as his finger and hand grows.  At some point, Zeke may have another surgery to reduce that mass of tissue or he may not.  It just depends.  He can bring this thumb and new finger completely together.  In general, his new finger has not made much difference in his fine motor skills.  Zeke has always had amazing fine motor skill using the half a pointer and thumb to pinch and grip.  He really doesn't use his new finger for that type of stuff.  But the new finger does give him a much wider grip and it does make it easier to hold onto larger things.  He doesn't use it every single time he wants to grip something but I do see him using occasionally for things like balancing his silverware or holding a ball.  If you think about your own hands, that third finger really plays more a supportive role rather than taking center stage and I think that's what we are seeing with Zeke's finger.  He has done no physical therapy with it which is apparently pretty normal for this type of surgery.

A few pics:

I explained to Zeke that I was taking these pictures to help other moms and dads who were trying to decide if they should have this surgery done on their child and I asked him to grab something with his new finger.  He was in the middle of watching Power Rangers and could not be interrupted so this is as good as it gets.