Large digits are also called macrodactyly. This uncommon condition can be quite dramatic in appearance. I have previously blogged on the topic of macrodactyly- here is the previous Post. I want to share a few pictures from a single case as a way to demonstrate a typical progression.
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.|
The hand looks much better although there is swelling in the hand. Motion is very good and the patient is happy and the family is happy. Over time, the index finger slowly increased in size but not to the degree that the long finger was enlarged. We did several debulking procedures to help the finger avoid dramatic growth.
|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.
My Bio at Washington University
Hi doc, I'm Finnora from Indonesia. My son Jacob (4) also has similar case on his right index and middle finger. We are wondering what's the best option for him. If you could kindly help us to share your opinion, we will be very thankful. My email is firstname.lastname@example.org
Thank you for your time doc.
Hello Finnora. Thank you for the question. It is important to find a hand surgeon with some experience. Depending on the exact size of the fingers, the concept is to either control the growth of the fingers (through the growth plates) or amputate the fingers if dramatically too large. I realize that this advice is only somewhat helpful but there are many factors that affect this treatment decision.
I am maneesh from India. My 14 months old son has similar case(look like in a picture). His little finger of left hand is big campare to other to others.he has no pain in his that finger.he is healthy. Some time his left arm above the plam is coarse camapre to right hand.
Plz doctor suggest me what I do. Any treatment sugesst me.
Small finger macrodactyly is very uncommon. I am glad your son is otherwise healthy and that he has no pain. I do believe that he needs to be examined by a physician or surgeon who is familiar with macrodactyly (I cannot, unfortunately, suggest any treatment).
Commenting as I was given your name by Don Morris on an MD support page awhile back, I’ve been dipping my toes into looking into surgery as I have noticed some growth changes as I am now 23. I had an amputation and debulking when I was a child the appearance is very poor and I have a lot of built up tissue in my palm/wrist. If you have any advice or insight I’d appreciate it!
Please contact me offline if you would like to discuss further. email@example.com
My six year old daughter have same problem like left hand middle finger size big than rest of indexes.she has no problem about finger .she never felt pain.
This issue from her birth
.I have consulted some orthopedic specialist they we just debulk or remove tissue that giving growth.
Kindly give some contacts in Pakistan for this purpose.
Thank you for the question. I agree that your daughter would be best treated by a surgeon with experience in the treatment of macrodactyly. I have emailed you directly.