Department of Joint Surgery, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China.
Department of Burn and Plastic Surgery, Children's hospital of Chongqing Medical University, Chongqing, China.
J Orthop Surg Res. 2021 Feb 8;16(1):121. doi: 10.1186/s13018-020-02196-2.
The purpose of this study was to describe the clinical characteristics of macrodactyly of the foot through a large cohort of cases to further understand this rare entity.
Medical records, clinical photographs, plain radiographs, pathological findings, and intraoperative photographs of 95 feet of 93 patients were reviewed. Data including age; sex; laterality; ethnicity; birthplace; family history; and history of gestation, environment, whether smoking, or drinking during pregnancy were collected and analyzed.
Female patients (60%), left foot (56%), and static overgrowth (63%) were more prominent in the study cohort. Southern provinces (74%) and Han Chinese ethnicity (95%) predominated in terms of geographical region and demographic distribution, respectively. Multiple-toe involvement was 2.01-times more frequent than single-toe involvement. All five toes were involved with midline toes being most frequently affected overall and a medial distribution being more common than a lateral one. The forefoot was affected in 90 feet. The affected areas (toes and forefeet) were mostly located in the innervation of the affected medial plantar nerve (91%). The nerves showed enlargement in 49 feet, fatty infiltration in 25, a tortuous course in one, and were normal in 10 feet. Only six feet involved the musculature. Enlargement of phalanges and metatarsals were observed in 92 and 57 feet, respectively, and advanced bone maturation was seen in 63 feet. Twenty-two cases had syndactyly.
Macrodactyly of the foot is a rare congenital malformation with diverse clinical manifestations and multiple elements' involvement. It also presents the characteristics of nerve-mediated overgrowth and "nerve territory-oriented" deformity similar to that of macrodactyly of the hand.
本研究旨在通过大样本病例描述足部巨趾症的临床特征，以进一步了解这一罕见疾病。
回顾了 93 例 95 足的病历、临床照片、平片、病理结果和术中照片。收集并分析了包括年龄、性别、侧别、种族、出生地、家族史以及妊娠期间的环境、是否吸烟或饮酒等数据。
在研究组中，女性患者（60%）、左足（56%）和静止性过度生长（63%）更为突出。在地域分布上，南方省份（74%）和汉族（95%）占主导地位，而在人口统计学分布上，多趾受累的发生率是单趾受累的 2.01 倍。所有五个脚趾都受累，中线脚趾最常受累，内侧分布比外侧分布更常见。90 足前足受累。受累区域（脚趾和前足）主要位于受影响的足底内侧神经支配区域（91%）。49 足神经增粗，25 足脂肪浸润，1 足迂曲，10 足正常。仅 6 足累及肌肉。92 足趾骨和 57 足足骨增大，63 足骨成熟度较高。22 例合并并趾。
足部巨趾症是一种罕见的先天性畸形，具有多种临床表现和多元素受累的特点。它还具有神经介导过度生长和“神经支配区域”畸形的特征，与手部巨趾症相似。
