Macrodactylie

Abstract

There are two types of congenital enlargement of the finger. In one type, the finger is enlarged as part of a syndrome or because of a tumor or a malformation. In the other, the finger is enlarged as an isolated anomaly called "true macrodactyly", with an abundance of fat mainly on the palmar side of the finger. This condition is a rare congenital malformation and the etiology is unknow. The enlarged portion of the finger or the hand can be in a distribution of a major peripheral nerve, most often the median nerve. This condition is called nerve territory-oriented macrodactyly. Macrodactyly can be static, present at birth and does not increase disproportionately with growth, or progressive with a disproportionate growth of the digit. Treatments are difficult and challenging. The goals of operative treatments are: to control the growth in children, mainly with epiphysiodesis; to reduce the size of the finger with resection of skin and subcutaneous tissue with occasionally recession osteotomy, angulation osteotomy and arthrodesis; amputation in severe progressive macrodactyly. Parents should be informed of the potentiel number of operations necessary and of the limitation of function.

Profile of congenital digital anomalies in children seen in two tertiary health facilities in Southern Nigeria

“…This highlights the rarity of this type of digital anomaly in our region. [16][17][18] The more complex cases which tended to be combinations of anomalies were more intricate and often required multi-disciplinary approach involving paediatric and plastic and reconstructive surgeons. Microsurgical toe-to-hand transfers as well as the non-vascular phalangeal transfers which have been reported with excellent results in cases of absent digits were not feasible in our practice due to lack of requisite equipment and manpower.…”

Vraie macrodactylie avec orientation nerveuse

“…Dans ce tissu, on trouve plusieurs nodules composés de cartilage hyalin avec parfois formation de cartilage et d'os. Il existe une accélération du remodelage comme en témoigne la présence de nombreux ostéoblastes et ostéoclastes [3].…”

“…L'échographie: Peut retrouver un élargissement fusiforme du nerf avec prolifération graisseuse dissociant les fascicules nerveux et un éventuel rétrécissement dans le canal carpien [3, 4].…”

Lipofibromatous hamartoma of median nerve: A review article

“…On physical examination, the mass is commonly described as soft, firm, nonfluctuant, mobile, and minimally tender. Macrodactyly, when present, follows the course of the median nerve [29] . Syndactyly has also been reported to be associated with LHF [30] .…”