Amputation of left foot macrodactyly improve quality of life for a toddler: a case report from Tigray, Northern Ethiopia

Abstract

Introduction and importance: 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. Case presentation: 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. Clinical discussion: 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. Conclusion: 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.