The moment Jason Woodle first saw his newborn son in the delivery room, his immediate gut reaction was to count the boy’s fingers and toes. The quick scan revealed something unusual.
“I looked at the attending pediatrician and I said, I think we have some missing digits here,” Woodle, who lives in Charlottesville, Virginia, told TODAY. “It was quite a surprise for everyone in the room… it was actually quite unnerving.”
Baby Connor was born in 2012 without his thumbs, a rare condition called thumb aplasia that affects about one out of every 100,000 infants. The exact cause is a mystery.
While a missing finger or two might not sound like a big deal in the full spectrum of birth defects, Woodle and his wife worried about what it would mean for Connor’s future.
“My first thoughts were: How is he going to be able to function in the world? Everything from five-fingered gloves to being able to reel in a fishing rod to being able to play a video game,” he said. “Even something as simple as hitting a space bar on a keyboard – we take our thumbs for granted.”
Indeed, the opposable thumb is a marvel of anatomical design, allowing us to grasp and hold things, and giving us the ability to pinch and grip. Try opening a bottle or tying your shoes without it and you quickly realize its worth.
As he grew, Connor learned to pick up objects between his index and middle finger, crab-like, Woodle said.
People can obviously survive without thumbs, but even simple tasks become very challenging, said Dr. Bobby Chhabra, an orthopedic surgeon and co-founder of the University of Virginia Hand Center. Certain genetic disorders can cause deformities in the hands of a fetus, which develop in the first two months of a pregnancy, he said.
“It’s very unusual to have a child born without both thumbs and still have four, fully-functioning normal other fingers,” Chhabra noted about Connor’s case.
So the doctor set out to create thumbs from the boy’s index fingers using a procedure called digit pollicization. Each complex, multi-hour surgery — one per hand — involved rotating Connor’s index finger, shortening it, placing it where the thumb would normally be and then reconnecting the finger’s blood vessels and nerves.
Chhabra also had to make sure the digit would be able to grow normally, so that when Connor was an adult, he wouldn’t be stuck with a baby-sized thumb.
“It’s an incredibly elegant operation,” Chhabra said. “This is one of the more complex operations that I do because a child’s hand is very small. The structures, blood vessels, nerves — everything is miniscule.”
Connor was 1 when the first surgery took place last year — the optimum age for digit pollicization because that’s when children are learning fine motor skills and have an incredible ability to adapt, Chhabra said.
If an adult were to undergo the same procedure, he would have a hard time learning how to use his new thumb because the mature brain doesn’t have the same adaptability, Chhabra added.
Woodle still remembers the moment he first saw his son’s brand new thumb.
“I was in tears. It was a big, big thing for me to be able to see that,” Woodle said. “For him, too. For his first hand, when we took the cast off he held his hand up and he kind of stared at his hand.”
With both surgeries complete, the boy, who is now 2 1/2, is “doing fantastic,” Chhabra said. He can pick up tiny things, lift heavy objects, like a sippy cup filled with milk, and use crayons.
The surgeries have left Connor with three fingers and a thumb on each hand, though many people don’t notice he’s missing a finger, Chhabra said.
“In these children, the hope is to provide them a full life and the ability to do anything that any other child can do,” he noted. “The long-term outlook is very good.”