Single Stage Reduction Operation for Treatment of Toe Macrodactyly in Skeletally Immature Patients

Suk-Joong Lee; Hyun-Joo Lee; Poong-Taek Kim

doi:10.4055/jkoa.2016.51.3.260

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Lee, Lee, and Kim: Single Stage Reduction Operation for Treatment of Toe Macrodactyly in Skeletally Immature Patients

Case Report

Journal of the Korean Orthopaedic Association 2016; 51(3): 260-265.

Published online: 22 June 2016

DOI: https://doi.org/10.4055/jkoa.2016.51.3.260

Single Stage Reduction Operation for Treatment of Toe Macrodactyly in Skeletally Immature Patients

Suk-Joong Lee, M.D., Hyun-Joo Lee, M.D.^*, Poong-Taek Kim, M.D.^†

Department of Orthopaedic Surgery, Dongsan Medical Center, Daegu, Korea.

^*Department of Orthopaedic Surgery, Kyungpook National University Hospital, Daegu, Korea.

^†Department of Orthopaedic Surgery, Daegu Park's Hospital, Daegu, Korea.

Correspondence to: Hyun-Joo Lee, M.D. Department of Orthopaedic Surgery, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu 41944, Korea. TEL: +82-53-420-5628, FAX: +82-53-422-6605, lidmania@daum.net

Received 22 July 2015 Revised 2 October 2015 Accepted 16 November 2015

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Macrodactyly is one of the most difficult congenital anomalies to treat. Treatment of macrodactyly requires surgical intervention because it gives rise to esthetic, social, and functional disability including difficulty in wearing shoes. A myriad of surgical techniques has been introduced to reduce the size of macrodactyly. However, treatment of toe macrodactyly has not been spotlighted due to less significant functional and social issues compared with finger macrodactyly. We treated two patients with toe macrodactyly by single stage reduction operation.

Keywords: toes, macrodactyly, single stage, reduction operation

Figures and Tables

Figure 1

Feet of a 25-month old girl showed macrodactyly involving the second, third, and fourth toes. Note the size of shoes were fit to the affected right foot.

Figure 2

Radiograph of the right foot showed divergence of metatarsi. No osteochondral lesion was shown.

Figure 3

Immediate postoperative simple radiograph.

Figure 4

Nine years and six months after surgery, the second and fourth toes are still larger than those of the left foot. However, the proportion between the great toe and other toes improved.

Figure 5

Radiograph showed that bone union at the proximal phalangeal joints was achieved and the affected toes have a larger width at nine years and six months after surgery.

Figure 6

Right third toe of a six-year-old boy showed enlargement in circumference.

Figure 7

A six-year-old boy showed enlarged left third toe. The left third metatarsal and phalangeal bones did not show obviously enlarged bone.

Figure 8

The excessive subcutaneous fat tissue and skin were removed along with the ipsilateral digital nerve.

Figure 9

At six weeks after surgery, the circumference had decreased.

Notes

^{CONFLICTS OF INTEREST} The authors have nothing to disclose.

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