Removal of Nonfunctional Extra Digit
1. Prevention of accidental avulsion or torsion around
2. Cosmetic correction at parental request
3. Consider surgical excision as an alternative to prevent
the development of amputation neuromas (1,2)
1. Concomitant illness in infant
This is an elective procedure that is painful when
the clamp is applied. To prevent accidental avulsion of
appendage if extra digit on a narrow base were to
become entangled, apply a soft dressing or adhesive
bandage until infant is stable enough for removal.
3. Additional anomalies where further surgical correction
4. Base of extra digit >2 mm wide
5. Bone crossing the isthmus between extra digit and hand
1. Antiseptic solution and swabs appropriate for major
3. Surgical silk suture, 3-0 or 4-0
1. Perform procedure only on stable, healthy infant
2. Consider surgical evaluation for any questionable digit.
b. When extra digit is on radial side of hand or is a
d. When there appears to be a joint at the base
e. When bony structures are present in the digit as
3. Consider surgical evaluation for any questionable skin tag.
a. When tag may be used for ear or nasal deformity
b. When tag is large or in critical areas
4. Apply hemostat to base of extra digit prior to placing
a. Allows closer amputation without residual bump
b. Allows faster autoamputation or removal of most of
Removal of Nonfunctional Digit (Fig. 46.1)
1. Apply local anesthetic cream to appendage and base.
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