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Macrodactyly of the foot
Chia Hsieh Chang1, S Jay Kumar, Eric C Riddle
1Alfred I. duPont Hospital for Children, Wilmington, DE 19899, USA.
The Journal of Bone and Joint Surgery. American Volume
|July 11, 2002
Summary
Ray resection offers the best outcomes for foot macrodactyly involving lesser toes. Treatment for great toe macrodactyly often yields fair results, necessitating further interventions.
Area of Science:
- Orthopedics
- Podiatry
- Surgical Treatment
Background:
- Macrodactyly of the foot presents unique challenges in treatment.
- Optimal management strategies for foot macrodactyly require clear guidelines.
Purpose of the Study:
- To address the complications of foot macrodactyly.
- To establish treatment guidelines for macrodactyly of the foot.
Main Methods:
- A retrospective review of seventeen feet (fifteen patients) with macrodactyly.
- Classification into two groups: lesser toe involvement (Group A) or great toe involvement (Group B).
- Surgical interventions included toe amputation, ray resection, epiphysiodesis, phalanx amputation, and soft-tissue debulking, with radiographic assessment of metatarsal spread angle.
Main Results:
- Ray resection yielded good cosmetic and functional outcomes in Group A (lesser toe involvement).
- Toe amputation in Group A had suboptimal results.
- Great toe involvement (Group B) often resulted in fair outcomes, even with shortening procedures.
Conclusions:
- Ray resection is the preferred surgical approach for macrodactyly affecting lesser toes.
- Toe amputation is less effective and cosmetically undesirable for lesser toe macrodactyly.
- Macrodactyly of the great toe presents treatment challenges, often requiring further soft-tissue debulking for satisfactory results.