Thomas A. Brosky II


Macrodactyly is a rare and uncertain congenital deformity of the hands and feet. The condition may occur unilaterally or bilaterally, and syndactyly can be an occasional finding (1). Typically, the condition presents unilaterally and demonstrates a slight male predominance. Involvement of the fourth and fifth digits is rare. True macrodactyly can involve enlargement of phalanges, tendons, nerves, vessels, subcutaneous fat, nails, and skin (Fig. 75.6).

In 1967, Barsky (1) described two general forms of true macrodactyly. The “static type” is present at birth and enlarges proportionally with growth. Hypertrophy does not extend proximally to the digit. The second type is termed “progressive” since there is disproportionate growth of the affected digit. The deformity usually involves proximal tissue and progresses so rapidly that the patient presents at an early age with grotesque deformity. Rarely is there a family history of macrodactyly, which suggests that heredity does not play a part in this deformity (2).

Figure 75.6 Clinical appearance of macrodactyly in a young child.

Jul 26, 2016 | Posted by in MUSCULOSKELETAL MEDICINE | Comments Off on Macrodactyly

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