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Reconstruction and pathology in macrodactyly

R W Pho1, M Patterson, Y S Lee

  • 1Department of Orthopaedic Surgery, National University of Singapore.

Insights

This study details a macrodactyly case where a finger was surgically shortened and the nail bed reimplanted. Electron microscopy revealed nerve damage, specifically myelin sheath and axon degeneration.

Area of Science:

  • Hand surgery
  • Microsurgery
  • Neuropathology

Background:

  • Macrodactyly is a rare congenital condition characterized by disproportionate overgrowth of digits.
  • Surgical correction often involves complex procedures to restore function and aesthetics.
  • Understanding the underlying nerve pathology is crucial for surgical planning and outcomes.

Observation:

  • A case of macrodactyly involving digital shortening and proximal nail bed/root implantation via a vascularized pedicle was managed.
  • Surgical intervention aimed to address the digital overgrowth and associated nail deformities.
  • The procedure utilized microsurgical techniques for precise tissue transfer.

Findings:

  • Electron microscopy demonstrated focal and segmental degeneration of the myelin sheath.
  • Axonal neurofilaments also showed signs of degeneration in affected nerve tissues.
  • These neuropathological findings provide insights into the potential nerve involvement in macrodactyly.

Implications:

  • The findings highlight the importance of considering neuropathological changes in macrodactyly management.
  • Microsurgical techniques can be applied to complex digital reconstructions.
  • Further research may elucidate the relationship between macrodactyly and nerve degeneration.

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