This child presented to us a 8 months of age. He was otherwise healthy and there was no family history of any kind of of bone or joint problem. The family was obviously concerned.
|Macrodactyly on left hand. Note the very large long finger.|
|Macrodactyly appearance. The long finger is obviously too big. The other digits are not notably different.|
|Macrodactyly after surgery|
|Macrodactyly after excision of large digit.|
|Macrodactyly after excision. This is 7+ years later. The index finger has slowly grown larger.|
The bottom line is the macrodactyly and other overgrowth conditions are challenging for the family and for the treating physician. There are usually no easy solutions. We try to minimize the number of interventions while providing the best hand for long term function and appearance. The good news is that researchers are making progress. We believe all of these disorders like macrodactyly are related to a signaling mechanism which has malfunctioned. A cell receptor turns on, growth increases and macrodactyly (or hemihypertrophy, or tumors) result. Identification of the problem is the first step in fixing it.
Charles A. Goldfarb, MD
My Bio at Washington University