We believe this case emphasizes some peculiarities of gout:
1. Unaffected parts of a crippled digit can be transferred with the blood supply and effectively utilized in reconstructive procedures.
2. Osteogenesis will take place if bone has not been directly involved with a urate deposit.
3. Incomplete removal of tophi is not necessarily followed by return of the deforming overgrowth.
4. Wounds heal well even with extensive dissection and incomplete removal of the gouty lesions.
5. Early surgical intervention of progressive tophi of the hands is recommended.