Comprehensive digital debulking and reconstruction for pediatric foot macrodactyly
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Published on: April 7, 2026
Aiping Yu1, Lei Huang1, Razzokov Anvar Sardor O G'li2
1Department of Plastic and Reconstructive Surgery, Shanghai Jiaotong University School of Medicine Affiliated 9th People's Hospital, Shanghai 200011, China.
Background:
Traditional treatments for pediatric foot macrodactyly often yield suboptimal outcomes and require multiple surgeries. This study evaluates a novel single-stage technique: Comprehensive Digital Debulking and Reconstruction (CDDR).
Methods:
CDDR uses pedicled thin flaps for radical soft-tissue excision, combined with osteotomy and joint fusion. We retrospectively reviewed 36 children (mean age, 5.4 years) treated with this procedure. Outcomes included morphometric ratios, AOFAS and Maryland scores, Vancouver Scar Scale, parental satisfaction, and complications.
Results:
At mean 3.0-year follow-up, all toe, forefoot, and nail size ratios significantly improved (all p < 0.01). AOFAS scores increased from 57.9 to 77.3 and Maryland scores from 75.5 to 91.4. Mean Vancouver Scar Scale was 1.6; all parents were satisfied. Complications included skin necrosis (5.6%), hypertrophic scar (5.6%), toe deviation (2.8%), and delayed union (2.8%).
Conclusion:
CDDR is a safe, effective, single-stage toe-preserving alternative to amputation for pediatric foot macrodactyly.
Level Of Evidence:
III.
