J Korean Orthop Assoc.  2016 Jun;51(3):260-265. 10.4055/jkoa.2016.51.3.260.

Single Stage Reduction Operation for Treatment of Toe Macrodactyly in Skeletally Immature Patients

• Lee SJ
• Lee HJ
• Kim PT

• KMID: 2308588
• DOI: http://doi.org/10.4055/jkoa.2016.51.3.260

Abstract

Macrodactyly is one of the most difficult congenital anomalies to treat. Treatment of macrodactyly requires surgical intervention because it gives rise to esthetic, social, and functional disability including difficulty in wearing shoes. A myriad of surgical techniques has been introduced to reduce the size of macrodactyly. However, treatment of toe macrodactyly has not been spotlighted due to less significant functional and social issues compared with finger macrodactyly. We treated two patients with toe macrodactyly by single stage reduction operation.

Keyword

toes; macrodactyly; single stage; reduction operation

MeSH Terms

Fingers
Humans
Shoes
Toes*

Figure

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  Figure 1 Feet of a 25-month old girl showed macrodactyly involving the second, third, and fourth toes. Note the size of shoes were fit to the affected right foot.

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  Figure 2 Radiograph of the right foot showed divergence of metatarsi. No osteochondral lesion was shown.

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  Figure 3 Immediate postoperative simple radiograph.

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  Figure 4 Nine years and six months after surgery, the second and fourth toes are still larger than those of the left foot. However, the proportion between the great toe and other toes improved.

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  Figure 5 Radiograph showed that bone union at the proximal phalangeal joints was achieved and the affected toes have a larger width at nine years and six months after surgery.

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  Figure 6 Right third toe of a six-year-old boy showed enlargement in circumference.

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  Figure 7 A six-year-old boy showed enlarged left third toe. The left third metatarsal and phalangeal bones did not show obviously enlarged bone.

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  Figure 8 The excessive subcutaneous fat tissue and skin were removed along with the ipsilateral digital nerve.

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  Figure 9 At six weeks after surgery, the circumference had decreased.

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