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