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巨指症的序贯手术矫正:一例报告及文献综述

Sequential Surgical Correction of Macrodactyly: A Case Report and Literature Review.

作者信息

Russo Aurelio Pio, Szilveszter Monika, Șuta Călin, David Camelia, Vunvulea Vlad, Pastorello Ylenia, Simon-Szabó Zsuzsánna, Incze-Bartha Sándor, Dénes Lóránd, Incze-Bartha Zsuzsánna

机构信息

Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, Târgu Mureș, ROU.

Department of Plastic and Reconstructive Surgery, Emergency County Hospital Târgu Mureș, Târgu Mureș, ROU.

出版信息

Cureus. 2024 Sep 7;16(9):e68913. doi: 10.7759/cureus.68913. eCollection 2024 Sep.

DOI:10.7759/cureus.68913
PMID:39381491
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11459114/
Abstract

This report discusses the case of a young female patient diagnosed with macrodactyly of the toes, a condition that significantly affected her daily life. From the age of three to 11, she underwent treatment due to the severe impact of her deformity, particularly on her ability to move comfortably and wear suitable footwear. The patient's macrodactyly presented a complex clinical challenge, necessitating multiple surgical procedures to manage it effectively. These surgeries included soft tissue reduction to decrease the bulk of the enlarged digits, epiphysiodesis to halt the growth of the affected bones, and amputations to address the disproportionate enlargement of the toes. Each surgical intervention was aimed at improving both the function and appearance of the affected foot, with a focus on enhancing the patient's mobility and comfort. Despite the difficulties associated with recovery, the patient showed significant improvements in her ability to walk and in the aesthetic appearance of her foot. This case underscores the importance of developing individualized treatment plans that consider the unique needs of each patient and setting realistic expectations for outcomes. It also highlights that, while surgical interventions can lead to functional and cosmetic benefits, the extent of these improvements may be limited due to the inherent complexities of macrodactyly. The case calls attention to the need for ongoing research and the accumulation of clinical experience to refine treatment approaches for macrodactyly. Such advancements are crucial for optimizing therapeutic outcomes and improving the quality of life for patients affected by this rare condition.

摘要

本报告讨论了一名被诊断为脚趾巨指症的年轻女性患者的病例,这种病症严重影响了她的日常生活。从三岁到十一岁,由于畸形的严重影响,尤其是对她舒适移动和穿合适鞋子能力的影响,她接受了治疗。患者的巨指症带来了复杂的临床挑战,需要多次外科手术才能有效处理。这些手术包括软组织缩减以减少增大手指的体积、骨骺阻滞以阻止受影响骨骼的生长,以及截肢以解决脚趾不成比例的增大问题。每次手术干预的目的都是改善患足的功能和外观,重点是提高患者的活动能力和舒适度。尽管恢复过程存在困难,但患者在行走能力和足部美观方面都有了显著改善。这个病例强调了制定个性化治疗方案的重要性,该方案要考虑每个患者的独特需求,并对治疗结果设定现实的期望。它还强调,虽然手术干预可以带来功能和美容方面的益处,但由于巨指症固有的复杂性,这些改善的程度可能有限。该病例提请注意需要持续研究和积累临床经验,以完善巨指症的治疗方法。这样的进展对于优化治疗效果和提高受这种罕见病症影响患者的生活质量至关重要。

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本文引用的文献

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J Plast Surg Hand Surg. 2023 Feb-Dec;57(1-6):115-121. doi: 10.1080/2000656X.2021.2017293. Epub 2022 Jan 8.
2
[Clinical characteristics of 170 cases of macrodactyly].170例巨指症的临床特征
Beijing Da Xue Xue Bao Yi Xue Ban. 2021 Jun 18;53(3):590-593. doi: 10.19723/j.issn.1671-167X.2021.03.025.
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Clinical characteristics of 93 cases of isolated macrodactyly of the foot in children.93 例儿童单纯性巨趾症的临床特点。
J Orthop Surg Res. 2021 Feb 8;16(1):121. doi: 10.1186/s13018-020-02196-2.
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Precise Resection of Macrodactyly Under Assistance of Three-Dimensional Reconstruction Technology: A Case Report.三维重建技术辅助下巨指症的精准切除:一例报告
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Isolated gigantism of digits.孤立性手指巨大症
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The use of the Tsuge procedure for pedal macrodactyly: relevance in pediatric orthopedics.津下手术在足部巨指症治疗中的应用:在小儿骨科中的相关性
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Presentation and treatment of macrodactyly in children.儿童巨指(趾)症的临床表现与治疗
J Hand Surg Am. 2013 Nov;38(11):2112-23. doi: 10.1016/j.jhsa.2013.08.095. Epub 2013 Sep 20.
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Macrodactyly - options and outcomes.巨指症——治疗选择与预后
J Hand Surg Eur Vol. 2013 Mar;38(3):297-303. doi: 10.1177/1753193412451232. Epub 2012 Jun 26.
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Ray amputation for the treatment of macrodactyly in the foot: report of three cases.雷氏截肢术治疗足部巨指(趾)症:三例报告
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