Quadrant Flap for Fingertip Reconstruction in Macrodactyly: Technique and Case Report

Macrodactyly is a serious and rare disease and considered one of the most difficult pathologies to treat. There is no rule and the treatment for each patient must be tailor-made, depending on the location and degree of macrodactyly. Although amputation is a valid option for adult patients, nail preservation and reconstruction are important and has a direct impact on the treatment outcome, both aesthetically and on the patient's self-esteem. We have used a wide, z-shaped fingertip flap associated with the preservation of a nail quadrant, bone shortening and distal interphalangeal arthrodesis. We have obtained good functional and aesthetic outcomes with this 'quadrant flap' technique. The technique allows decreasing digit size and volume and reconstruction of the nail complex and finger pulp. Level of Evidence: Level V (Therapeutic).