Wei Chen1, Xiaofei Tian2,3,4,5,6, Lu Chen7,8,9,10,11, Wei Huang12. 1. Department of Joint Surgery, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China. 2. Department of Burn and Plastic Surgery, Children's hospital of Chongqing Medical University, Chongqing, China. 3. Department of Ultrasound, Children's hospital of Chongqing Medical University, No. 136 Zhongshan Er Road, Yuzhong District, 400014, Chongqing, China. 4. China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing, China. 5. National Clinical Research Center for Child Health and Disorders, Chongqing, China. 6. Chongqing Key Laboratory of Pediatrics, Chongqing, China. 7. Department of Ultrasound, Children's hospital of Chongqing Medical University, No. 136 Zhongshan Er Road, Yuzhong District, 400014, Chongqing, China. cw4511@163.com. 8. China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing, China. cw4511@163.com. 9. National Clinical Research Center for Child Health and Disorders, Chongqing, China. cw4511@163.com. 10. Chongqing Key Laboratory of Pediatrics, Chongqing, China. cw4511@163.com. 11. Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China. cw4511@163.com. 12. Department of Joint Surgery, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China. huangw2016@163.com.
Abstract
BACKGROUND: The purpose of this study was to describe the clinical characteristics of macrodactyly of the foot through a large cohort of cases to further understand this rare entity. METHODS: Medical records, clinical photographs, plain radiographs, pathological findings, and intraoperative photographs of 95 feet of 93 patients were reviewed. Data including age; sex; laterality; ethnicity; birthplace; family history; and history of gestation, environment, whether smoking, or drinking during pregnancy were collected and analyzed. RESULTS: Female patients (60%), left foot (56%), and static overgrowth (63%) were more prominent in the study cohort. Southern provinces (74%) and Han Chinese ethnicity (95%) predominated in terms of geographical region and demographic distribution, respectively. Multiple-toe involvement was 2.01-times more frequent than single-toe involvement. All five toes were involved with midline toes being most frequently affected overall and a medial distribution being more common than a lateral one. The forefoot was affected in 90 feet. The affected areas (toes and forefeet) were mostly located in the innervation of the affected medial plantar nerve (91%). The nerves showed enlargement in 49 feet, fatty infiltration in 25, a tortuous course in one, and were normal in 10 feet. Only six feet involved the musculature. Enlargement of phalanges and metatarsals were observed in 92 and 57 feet, respectively, and advanced bone maturation was seen in 63 feet. Twenty-two cases had syndactyly. CONCLUSIONS: Macrodactyly of the foot is a rare congenital malformation with diverse clinical manifestations and multiple elements' involvement. It also presents the characteristics of nerve-mediated overgrowth and "nerve territory-oriented" deformity similar to that of macrodactyly of the hand.
BACKGROUND: The purpose of this study was to describe the clinical characteristics of macrodactyly of the foot through a large cohort of cases to further understand this rare entity. METHODS: Medical records, clinical photographs, plain radiographs, pathological findings, and intraoperative photographs of 95 feet of 93 patients were reviewed. Data including age; sex; laterality; ethnicity; birthplace; family history; and history of gestation, environment, whether smoking, or drinking during pregnancy were collected and analyzed. RESULTS: Female patients (60%), left foot (56%), and static overgrowth (63%) were more prominent in the study cohort. Southern provinces (74%) and Han Chinese ethnicity (95%) predominated in terms of geographical region and demographic distribution, respectively. Multiple-toe involvement was 2.01-times more frequent than single-toe involvement. All five toes were involved with midline toes being most frequently affected overall and a medial distribution being more common than a lateral one. The forefoot was affected in 90 feet. The affected areas (toes and forefeet) were mostly located in the innervation of the affected medial plantar nerve (91%). The nerves showed enlargement in 49 feet, fatty infiltration in 25, a tortuous course in one, and were normal in 10 feet. Only six feet involved the musculature. Enlargement of phalanges and metatarsals were observed in 92 and 57 feet, respectively, and advanced bone maturation was seen in 63 feet. Twenty-two cases had syndactyly. CONCLUSIONS: Macrodactyly of the foot is a rare congenital malformation with diverse clinical manifestations and multiple elements' involvement. It also presents the characteristics of nerve-mediated overgrowth and "nerve territory-oriented" deformity similar to that of macrodactyly of the hand.
Entities:
Keywords:
Clinical characteristics; Foot malformation; Macrodactyly of the foot