Two-Stage Operation Over a Period of 7 Years for a Patient with Macrodactyly: A Case Report

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Macrodactyly of the toe is a rare congenital anomaly characterized by the overgrowth of a digit or multiple digits in the foot.Barsky 1) and Kotwal and Farooque 2) described that all components of the digits, including the phalanges, tendons, nerves, vessels, subcutaneous fat, fingernails, and skin, become enlarged, while the metatarsals remain unaffected.Owing to its low incidence, few reports or research articles exist on macrodactyly, and the etiology is largely unknown.Two distinguishing types of toe macrodactyly have been observed; the static type, where digits grow commensurately with the foot, and the progressive type, where digits grow faster than the rest of the limb.Additionally, Flatt 3) described four types of macrodactyly; type 1 macrodactyly with nerve lipofibromatosis, type 2 macrodactyly with neurofibromatosis, type 3 macrodactyly associated with hyperostosis, and type 4 macrodactyly associated with hemihypertrophy.Although social withdrawal seems to occur less frequently in those with macrodactyly of the toe than in those with macrodactyly of the fingers, functional discomfort, such as difficulty in wearing shoes or running, is an important factor.This condition is more extreme in the toe, leading to additional discomfort due to exacerbated pain.Macrodactyly is one of the most difficult anomalies to treat.Although there are various surgical techniques for toe macrodactyly, including amputation, osseous structure reduction, soft tissue debulking, and epiphysiodesis, the best treatment strategy remains unclear.