Management

The surgical treatment of brachydactyly is rarely indicated. Usually, the patient presents late with good function and little in the way of functional impairment. Surgery addresses specific issues:

• angulated digits:
  • often due to longitudinally bracketed epiphyses; epiphysiolysis may permit adequate subsequent growth in the child
  • mature defects may require opening wedge osteotomies with or without bone grafts
• cosmetically short digit:
  • rarely is surgery indicated
  • can be addressed with techniques such as:
    • distraction osteogenesis; substantial lengths can be obtained
    • single-stage lengthening with bone grafts
    • nonvascularised toe phalangeal transfers