1 in a Million: Rare Surgery in St. Louis Corrects Toddler's Eight-Fingered Hand

A family traveled from Turkey to St. Louis for a procedure addressing a condition documented in fewer than 100 cases worldwide.

Elisa, 18 months old, was born with eight fingers on her left hand and diagnosed with Ulnar Dimelia, also called Mirror Hand Syndrome. Dr. Charles Goldfarb, Chief of Orthopedic Surgery at St. Louis Children's Hospital, said he has rarely encountered it. "Mirror Hand is incredibly uncommon, and even surgeons like myself who take care of a great deal of kids almost never see this in their career. So, it's really uncommon. Numbers are hard to come by, but one in a million or less is probably about right," Goldfarb said.

The syndrome affects the forearm's bone structure and limits how a patient moves the wrist and elbow. Patients are born without a radius bone, while shoulder movement is preserved. Goldfarb said the condition creates significant limitations in wrist and elbow motion.

Elisa's parents, Emircan and Gulten Buga, speak only Turkish and used a translator to communicate with the medical team. The family connected with Goldfarb's orthopedic surgery unit through the St. Louis Children's International Free Care Fund, which is supported by the St. Louis Children's Hospital Foundation. Goldfarb described initial consultations held over the phone and FaceTime. "From the very beginning, he was really warm, genuine, and gave us a lot of hope. Honestly, the trust and support he gave us played a huge role in our decision to come to St. Louis," Emircan Buga said.

Goldfarb led the surgical team that performed a three-hour reconstructive procedure on Jan. 30. Elisa is currently recovering from the operation. Emircan Buga said the family is grateful for the support provided, "both financially and psychologically."

Goldfarb said the operation was designed to improve her long-term abilities. "And it's so fun for me as a surgeon, who interacts with kids young and old, but at an early point in their life, to watch what happens after. And I do think a surgery like this is life-changing and will really help her succeed in all aspects," he said. Elisa's father said the family will remember the hand she was born with. "From now on, she will continue her life with more confidence and courage. But when we look back, we will miss that hand because that's how the story began," Emircan said.