Wu Jing-Heng, Tian Guang-Lei, Zhao Jun-Hui, Li Chun, Zhang You-Le, Pan Yong-Wei
Department of Hand Surgery, Fourth School of Medicine of Peking University, Beijing Jishuitan Hospital, Beijing 100035, China.
Zhonghua Wai Ke Za Zhi. 2008 Apr 1;46(7):514-7.
To analyze the clinical characteristics of 73 cases of macrodactyly.
Review the incidence, distribution, characteristic, X-rays, pathogenesis and treatment of involved digits on the base of the clinical documents of 73 macrodactyly which were treated from 1965 to 2006. Twenty-eight cases had been followed-up.
Unilateral involved 71 cases, bilateral involved 2 cases. In upper deformities, the most involved digit was the index finger, followed by thumb and middle finger enlargement. In lower deformities, the second toes were affected more. There were 12 cases of static macrodactyly, which were all presented at or soon after birth. Sixty-one cases were progressive macrodactyly: 39 cases presented at birth; 17 cases occurred at about 2 years old; 5 cases were found after age 2. Thirty-seven cases of progressive type presented digital deviation; 3 cases associated with syndactyly; 16 cases complicated with thenar eminence hypertrophy; 8 cases of multiple-digit involved combined with palm and forearm hyperplasia.
Macrodactyly in hand has a preference for the median nerve territory, mainly involving index, thumb and middle finger. Pedal macrodactyly prefers medial plantar nerve territory, the second toe is the most commonly affected. The progressive macrodactyly is more common than static. It may present at birth and combine with syndactyly, digital deviation, thenar eminence hypertrophy, palm and forearm hyperplasia.
分析73例巨指症的临床特征。
根据1965年至2006年收治的73例巨指症临床资料,回顾其发病率、分布、特点、X线表现、发病机制及患指治疗情况。对其中28例进行了随访。
单侧受累71例,双侧受累2例。上肢畸形中,最常受累的手指为示指,其次为拇指及中指增粗。下肢畸形中,第二趾受累较多。静止型巨指症12例,均在出生时或出生后不久出现。进行性巨指症61例:39例出生时即有表现;17例在2岁左右出现;5例在2岁以后发现。进行性巨指症中37例出现手指偏斜;3例合并并指;16例合并鱼际肌肥大;8例多手指受累合并手掌及前臂增生。
手部巨指症好发于正中神经分布区域,主要累及示指、拇指及中指。足部巨指症好发于足底内侧神经分布区域,最常受累的是第二趾。进行性巨指症较静止型更为常见。可在出生时出现,并可合并并指、手指偏斜、鱼际肌肥大、手掌及前臂增生。