Local gigantism or isolated macrodactyly refers to significant but isolated enlargement of a digit, unrelated to any other anomalies.
A 5-year-old boy from a rural area presented to the outpatient orthopedic clinic in the city with complaints of an enlarged index finger of the left hand. The doctors, on a clinical basis, made a working diagnosis of macrodactyly.
History:
The patient’s mother revealed that they had observed the enlarged finger at birth. They noticed that only one finger, i.e. the index finger of the left hand was longer and larger than the other fingers of the same hand and the right hand. Since birth, the enlarged finger grew out of proportion. Family history did not reveal any congenital anomalies, overgrowth syndromes, or limb defects. bwin شركة
Examination:
On physical examination, the doctors noticed a healthy, well-nourished child who was developmentally appropriate to his age. The patient was not in distress, not the review of systems revealed any findings. The child had no other anatomical defects on examination except the macrodactyly of the left hand’s index finger.
Local examination of the affected (left) hand revealed symmetrically diffuse hypertrophy of the index finger with a slight curvature and an enlarged nail bed. On the extension of the distal phalanx, it showed abnormal hyperextension without eliciting pain. The macrodactyly was not associated with syndactyly. كازينو اون لاين The rest of the fingers of the left and the right hand had normal shape and function.
Serology revealed no abnormality. Plain radiographs of the hand showed abnormalities of bone and the soft tissues. Radiograph also revealed an angled distal phalanx.
The patient received a diagnosis of isolated macrodactyly.
The surgeons successfully performed surgical debulking and terminalization. There were no preoperative, intraoperative or postoperative complications. After that, the patient lost to follow-up.
Macrodactyly:
Macrodactyly is an extremely rare congenital anomaly. Usually, it is an isolated finding, but it may be associated with other syndromes such as neurofibrolipoma, angiomatosis, Milroy disease, Klipple-Trenaunay-Weber syndrome, Cowden syndrome, Proteus syndrome, and other rare hereditary diseases in any patient with macrodactyly.
Similarly, it is imperative to differentiate true macrodactyly from tumorous overgrowth. In the former case, all mesenchymal elements overgrowth, while in the latter, a single element gets tumorous. Examples of the latter are hemangioma, lymphangioma, or enchondroma.
Various surgical reconstruction options are available, but none would result in a normal-looking digit. However, the aim is always to restored normal function and aesthetics as closely as possible. اربح المال من الانترنت
References:
Hart, Erin S.; Grottkau, Brian E. Isolated Macrodactyly of the Foot: Diagnosis and Treatment, Orthopaedic Nursing: July/August 2012 – Volume 31 – Issue 4 – p 212-215, DOI: 10.1097/NOR.0b013e31825dfcef
Cerrato F, Eberlin KR, Waters P, Upton J, Taghinia A, Labow BI. Presentation and treatment of macrodactyly in children. J Hand Surg Am. 2013 Nov;38(11):2112-23. doi: 10.1016/j.jhsa.2013.08.095. Epub 2013 Sep 20. PMID: 24060511.
Correspondence to: Prof. A. Yuksel, Istanbul University, Istanbul Medical School, Department of Obstetrics & Gynecology, ¸Capa – Istanbul, 34290, Turkey 12 June 2008
Hanif A, Shahid S (2020) Isolated Macrodactyly. Clin Med Img Lib 6:160. doi.org/10.23937/2474-3682/1510160