Macrodactyly

It is a descriptive term used for a disproportionately large digit noted at birth or that develops within the first years of life.

Most cases occur sporadically ( There may not be similar conditions among the family members). Some cases are associated with neurofibromatosis. Neurofibromatosis is often hereditary. Rarely it may occur as part of syndromes Eg : Olliers disease, Maffuci syndrome, Klippel- Trenaunay- Weber syndrome, Proteus syndrome.

The condition usually involves only one hand. Often more than one finger is affected. Index finger is the most commonly affected digit particularly in combination with thumb or long finger. The fingers are usually deviated to one side. The size and deviation of fingers increases over time. The function of fingers also deteriorates over time.

Macrodactyly is a disfiguring anomaly. Children are often subject to teasing and have social difficulties. Surgery is indicated for functional and aesthetic improvement. The progressive and diffuse nature prevents complete correction to normal. Available surgical options may be divided into three

1. Procedures that limit the ongoing growth.

2. Procedures that reduce the size of the digit.

3. Procedures that correct deviation of digit.

Outcomes are very dependent on the condition of the hand initially. Procedures improve the function and appearance of the digits. But no surgical procedure results in a normal appearance.