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The use of the Tsuge procedure for pedal macrodactyly: relevance in pediatric orthopedics

Morrell, Nathan T.; Fitzpatrick, Jennifer; Szalay, Elizabeth A.

Journal of Pediatric Orthopaedics B: May 2014 - Volume 23 - Issue 3 - p 260–265
doi: 10.1097/BPB.0000000000000046

Pedal macrodactyly is a rare clinical entity that poses a challenge to practicing pediatric orthopedic surgeons. Many treatment options have been proposed. In 1967, Kenya Tsuge proposed a method to decrease the length, width, and circumference of a macrodactylous digit, while maintaining the cosmetic benefit of keeping the nail. We retrospectively reviewed our experience with using this technique in four children (six toes) over a 4-year period. The surgery is described and our results reviewed. We believe that the Tsuge procedure is a technically feasible, effective, single-stage reconstructive technique for pedal macrodactyly that pediatric orthopedic surgeons should have in their armamentarium.

Department of Orthopaedics and Rehabilitation, University of New Mexico, Albuquerque, New Mexico, USA

Correspondence to Nathan T. Morrell, MD, MSC10 5600, 1 University of New Mexico, Albuquerque, NM 87131-0001, USA Tel: +1 505 272 4107; fax: +1 505 272 8098; e-mail:

© 2014 by Lippincott Williams & Wilkins, Inc.