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Macrodactyly

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The Pediatric Upper Extremity

Abstract

Macrodactyly is an extremely rare congenital anomaly causing either static or progressive overgrowth. This overgrowth can involve a single digit or an entire extremity. Macrodactyly can be an isolated phenomenon or part of a syndrome. The exact cause of this overgrowth remains unknown, but there are continued studies at the molecular level to determine a common pathway to link all types of macrodactyly.

The treatment options at this time are observation if the overgrowth is static and not causing functional impairment, or surgical to try to improve function and cosmesis. Splinting and therapy may be attempted, but there is no evidence to support their use. Surgical options range from nerve decompression, epiphysiodesis, debulking, terminalization, middle phalangectomy, osteotomies, and amputation. If the amputation involves the thumb, then pollicization may be considered.

There is no standardized tool to evaluate surgical outcomes for surgery treating macrodactyly. The condition is so rare, and varies so widely from case to case, that it remains one of the most challenging congenital hand anomalies that pediatric hand surgeons face.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Louisville, 210 East Gray Street Suite 1003, 40202, Louisville, KY, USA

    Amit Gupta

  2. Louisville Arm and Hand, Norton Orthopaedic Care, 315 East Broadway Suite 195, 40202, Louisville, KY, USA

    Charity S. Burke

Authors
  1. Amit Gupta
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  2. Charity S. Burke
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Correspondence to Amit Gupta .

Editor information

Editors and Affiliations

  1. Dept. of Orthopedics, University of Maryland School of Medicine, Baltimore, Maryland, USA

    Joshua M. Abzug

  2. Shriners Hospitals for Children, Philadelphia, Pennsylvania, USA

    Scott H. Kozin

  3. Shriners Hospitals for Children, Philadelphia, Pennsylvania, USA

    Dan A. Zlotolow

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Gupta, A., Burke, C.S. (2015). Macrodactyly. In: Abzug, J., Kozin, S., Zlotolow, D. (eds) The Pediatric Upper Extremity. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8515-5_16

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  • DOI: https://doi.org/10.1007/978-1-4614-8515-5_16

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-8513-1

  • Online ISBN: 978-1-4614-8515-5

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