Haftu Hansa, Gebrekidan Atsede, Gebrehiwot Teklu, Gebre Niguse Tsegay, Mahtsun Gebreegziabher
Mekelle University, College of Health Science, Pediatric, and Child Health.
College of Health Science, Mekelle University.
Ann Med Surg (Lond). 2023 Jun 20;85(8):4079-4082. doi: 10.1097/MS9.0000000000000998. eCollection 2023 Aug.
Macrodactyly is an uncommon, not inherited congenital malformation of the digit with unknown prevalence and path of pathogenesis. The condition was described in 1940 and since then 107 cases were reported. Manifestations may mislead the diagnosis of hemangiomas and lymphangiomatosis. There are different options for treatment without a clear consensus. The authors are presenting a macrodactyly case that improved the quality of his life after he underwent surgical amputation of the toes.
The authors had a case of a 2-year and 4-month-old male child presented with progressive growth of the left foot toes; which started since birth in the 4th toe and then involved 3rd and 5th toe later; resulting in deformity and difficulty in wearing shoes. Physical examination; showed left foot enlargements of the 3rd-5th toes. X-ray of the left foot was done he was diagnosed to have macrodactyly. Under general anesthesia metatarsophalangeal joint of the 4th-5th toe and distal interphalangeal joint of the 3rd toe, disarticulation was done. The patient is doing okay on follow-up for the last year.
Consistently with other case reports from Korea, Tanzania, and Congo our patient presented with a primary type of left foot macrodactyly in his early life, and he was successfully managed with amputation of the affected digits.
This is one of the rare cases which needs a high index of suspicion to diagnose and treat early to improve quality of life. Amputation is the most important management in resources limited areas.
巨指（趾）症是一种罕见的、非遗传性的先天性手指（趾）畸形，其患病率和发病机制尚不清楚。该病于1940年被描述，自那时起共报告了107例病例。其表现可能会误导血管瘤和淋巴管瘤病的诊断。治疗方法有多种，但尚无明确的共识。本文作者报告了一例巨指（趾）症病例，该患者在接受脚趾手术截肢后生活质量得到改善。
本文作者有一例2岁4个月大的男童，其左脚脚趾进行性生长；自出生起第四趾开始出现，随后累及第三趾和第五趾；导致畸形且穿鞋困难。体格检查显示左脚第三至第五趾增大。对其进行了左脚X线检查，诊断为巨指（趾）症。在全身麻醉下，对第四至第五趾的跖趾关节以及第三趾的远侧指间关节进行了关节离断术。该患者在过去一年的随访中情况良好。
与韩国、坦桑尼亚和刚果的其他病例报告一致，我们的患者在早年出现了原发性左脚巨指（趾）症，通过对受影响的趾进行截肢成功治愈。
这是少数需要高度怀疑才能早期诊断和治疗以提高生活质量的病例之一。在资源有限的地区，截肢是最重要的治疗方法。
