Wang Hai-hua, Tian Guang-lei, Zhu Yin, Zhang You-le, Zhao Jun-hui, Tian Wen
Department of Hand Surgery, Beijing Jishuitan Hospital, Beijing 100035, China.
Zhonghua Wai Ke Za Zhi. 2008 Mar 15;46(6):434-6.
To summarize the clinical characteristic and outcome of digital gigantism of the foot.
Retrospectively analyze the clinical documents of cases of digital gigantism of the foot. Twelve 12 cases with 13 feet in this study included 8 male and 4 female with an average 4.6-years-old. All the deformities were found at birth. Multiple toes involved were more than single toe, and tibial toe involved more than fibular. Forefoot was enlarged. All the phalanges involved and partial metatarsal bones were enlarged. Marked increase in subcutaneous fat was found in all cases in the operation which infiltrated interossei and articular capsules. The appearance of the nerves and its branches in the foot were normal and fat infiltrating was not discovered. The operation types included debulking, epiphyseal arrest, amputation, nerve stripping and anastomosis.
Seven cases were followed up with mean periods 25.6 months. Functional evaluation according to a criterion formulated by author revealed a result of 2 excellent, 2 good and 3 fair.
Digital gigantism of the foot is an uncommon congenital deformity of the foot characterized by overgrowth of both the soft-tissue and the osseous elements of the enlarged toe and forefoot. Surgical treatment is the unique method, and the goal is to reduce the size of the foot to allow fitting regular shoes and walking readily. There are several types of operations which to be chosen. The indication, the timing of operative intervention and the selection of operation type should be paid more attention.
总结足部巨指症的临床特征及治疗结果。
回顾性分析足部巨指症病例的临床资料。本研究共12例患者13只足,其中男性8例,女性4例,平均年龄4.6岁。所有畸形均在出生时即被发现。多趾受累多于单趾,胫侧趾受累多于腓侧趾。前足增大。所有受累趾骨及部分跖骨均增大。术中发现所有病例皮下脂肪均明显增多,脂肪浸润至骨间肌和关节囊。足部神经及其分支外观正常,未发现脂肪浸润。手术方式包括减容术、骨骺阻滞术、截肢术、神经剥离及吻合术。
7例患者获得随访,平均随访时间25.6个月。根据作者制定的标准进行功能评估,结果为优2例,良2例,可3例。
足部巨指症是一种罕见的先天性足部畸形,其特征为增大的趾及前足的软组织和骨组织过度生长。手术治疗是唯一的方法,目的是缩小足部尺寸以便能穿常规鞋子并方便行走。有多种手术方式可供选择。应更加关注手术指征、手术干预时机及手术方式的选择。