Hand it to Angie
A four-year-old Pietermaritzburg girl has become the first child in South Africa to have one of her toes transplanted to do duty as a finger.
Angelique Schröder was born without a right hand and most of her left arm — a condition called symbrachydactyly, which causes limb abnormalities.
The preschooler spent 11 hours under the knife at a Cape Town hospital two weeks ago as doctors amputated a toe from her right foot and grafted it as a pinky finger for her right hand.
Doctors had previously taken bones from both of her feet and grafted her a ring finger, middle finger, and a thumb, for her right hand.
But they felt she would need to have her toe grafted to her hand to ensure she was able to get a good enough grip, and decided to perform the operation, on July 25.
It was declared a success seven days later when the finger was seen to be “alive” on the hand, and last Sunday, Angelique started being able to move the new digit.
After the operation, she spent a week in ICU, as doctors monitored the finger for blood circulation.
She and her mother, Anna, return from Cape Town on Friday.
Her father, Dirk, told The Witness he was relieved after the anxious and emotional ride to get Angelique a functioning hand.
“Throughout the procedure, we were anxious. It was a long procedure and we were wondering whether she would make it. It was a scary time. When she was lying in ICU … we cried every day.
“Lots of feelings went through our heads. We wondered ‘have we created a monster’, ‘did we do the right thing’, but doctors assured us it’s not to make her look better, it’s for functionality.”
One of the surgeons, Dr Mark van der Velde, told The Witness that doctors were unable to lengthen fingers that had already been grafted to her hand, leading them to consider the toe transplant.
“The toe is removed along with tendons, veins and blood vessels and had to be joined up again through microsurgery,” he explained.
“I consulted surgeons from the U.S. and the UK for advice, and we decided to operate. It was a four-surgeon procedure which was tricky to orchestrate.”
After her birth, in 2014, Angelique’s father passed information about her to a friend who is a plastic surgeon in the U.S., and her case was discussed at a conference in Dallas.
Angelique’s case was referred to doctors in Cape Town, who then advised holding off surgery until she was slightly older.
She has now had bones from her foot grafted into a middle and ring finger, and a thumb, for her right hand. “Then, on Easter weekend, we went to Cape Town and doctors assessed her and they began planning the [toe] surgery.”
Schröder described Angelique as a resilient and positive girl, who loves playing with Barbie dolls and toy dinosaurs.
“She has amazed us. She tries all kinds of things, even riding a tricycle. She doesn’t believe she’s different, and we tell her God made her a special child,” the father said.
“We don’t know what the future holds for her. We still wonder how she will drive or write, but we have been researching aids, like voice-operated computers.”
He said the family was fundraising for the operation, as their medical aid would not cover it because it is classified as plastic surgery.
Schröder estimates the entire bill will come to R1,5 million. He said local schools have hosted events to raise money, and they have had some assistance from friends.