Purpose
To report the histopathological, electron microscopic, and immunohistochemical findings
of tissue samples obtained from patients with radial longitudinal deficiency (RLD)
and investigate the contribution of abnormality in soft tissues as a secondary driver
of deformity in RLD.
Methods
Specimens from radial-sided muscles and tendons were obtained at the time of surgery
(either radialization or centralization) from 14 patients with 16 limbs affected with
Bayne type 3 and type 4 RLD. The specimens were evaluated using light microscopy,
electron microscopy, and immunohistochemical examination.
Results
Among the 16 frozen muscle specimens, 6 (37%) showed normal muscle, while 10 (63%)
showed the presence of atrophic fibers. The 6 cases with normal muscle showed no abnormality
in fiber type distribution. Six patients showed predominance of type 1 muscle fibers.
None of the specimens had myofibroblasts; 4 of 16 specimens had mast cells, and 9
of 16 specimens showed the presence of platelet derived growth factor–positive cells.
Features of myofibroblasts (the presence of basal lamina, intercellular junctions,
or pinocytic vesicles) were not identified in any specimen on electron microscopy.
Conclusions
The histopathological, electron microscopic, and immunohistochemical findings, in
particular the absence of myofibroblasts, in tissue samples obtained from patients
with RLD, do not support the assumption of abnormality in soft tissues as a secondary
driver of deformity in RLD.
Clinical relevance
This study provides a preliminary insight into a possible role of soft tissues in
the development of the deformity in RLD.
Key words
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Article info
Publication history
Published online: August 25, 2021
Accepted:
July 6,
2021
Received:
April 15,
2020
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.
