Our second child was born six months ago. It's obvious there's something wrong with the tips of his thumbs. In both thumbs, the end of the thumb is tilted toward the other hand. What should we do about this? Will he outgrow the condition?

The first step is a medical exam with X-rays. Finding out the cause of the problem will guide you and the doctor in making treatment decisions. There could be a missing bone, an extra piece of bone, or even a fused joint. Most cases turn out to be one of three types of problems.

In Type one the bones of the thumb are normal but there is an extra triangular shaped bone. This extra bone is called an ossicle. It is wedged between the tip and the middle bone of the thumb pushing the tip to one side.

In Type two the bone at the tip of the thumb (called the distal phalanx) is abnormal. The growth plate at the end of the bone has a missing corner causing an angular deformity of the thumb.

In Type three, the middle bone of the thumb is abnormal. The growth center is triangular-shaped causing the bones to tip to one side.

Studies suggest early treatment gives the best result. Depending on the cause, he may not grow out of it. In fact, surgery to correct the problem may be needed. But again, a medical exam is needed before you can go any further with the "what ifs" of the situation.

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