Cape Town - A four-year-old who braved an 11-hour operation to become one of the youngest patients in the country to undergo a successful toe-to-finger transfer should start moving her finger and grasping large objects soon.
Angelique was born with bilateral symbrachydactyly, a congenital condition where there are various degrees of missing and shortened fingers.
Provincial health spokesperson Dwayne Evans said usually symbrachydactyly occurred only in one limb, but in Angelique’s case, she was born without a left hand and without fingers on her right hand, apart from a very rudimentary right thumb.
The surgery was researched and planned since Angelique’s parents, Dirk and Anna, approached Dr Mark van der Velde for assistance.
Performed at Red Cross War Memorial Children's Hospital, the surgery involved four surgeons and lasted 11 hours.
“She needed a wider grasp and, knowing that bone grafts don't grow in proportion to the child, I sought the help of the world's top pioneers of paediatric microvascular toe transfers who guided and encouraged me,” said Van der Velde.
“The difference between a bone graft and a whole toe transfer is that a graft is a single bone without a blood supply whereas a whole toe comes with a blood supply, nerves, tendons and nail
and confers far more length than a graft.”
When Angelique was six months old, doctors augmented her right, middle and ring fingers.
When she was one, Van der Velde performed a third bone graft to lengthen her thumb.
Evans said that over the past 15 years in South Africa, several toe transfers had been performed on adults who had lost digits in accidents, and a toe-to-thumb transfer in a child burn victim had been completed 10 years ago, but there had never been a paediatric toe transfer for a child born without fingers.