Macrodactyly | Diagnosis & Treatment

How is macrodactyly diagnosed?

Most of the time, a child’s macrodactyly is obvious soon after birth. Occasionally, however, the progressive type may not be detected until later in infancy, when continued enlargement occurs.

Your child’s doctor will perform the following diagnostic tests, such as x-rays and magnetic resonance imaging (MRI) to determine which underlying layers of tissue are enlarged:

  • x-rays
  • magnetic resonance imaging (MRI): a diagnostic procedure that uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within the body

How is macrodactyly treated?

Your child’s physician will discuss specific treatment options with you, and treatment depends on whether the condition occurs in the hand or the foot.

Your doctor’s goal will be to give your child optimal function of the affected area.

A hand can still be quite functional with a finger or two larger than the rest. Even a slightly enlarged toe may make wearing shoes impossible.

In mild cases, treatment for macrodactyly may involve observation or, in the case of an enlarged foot, shoe modification alone.

Surgical options for macrodactyly

Most of the time, however, surgery is required to correct macrodactyly. The surgery is complex because it involves multiple layers of tissue. It may take several surgical procedures to achieve the desired result.

Size-altering surgery will involve extensive observation and planning, because doctors will want to plot the rate of growth of your child’s normal digits versus the enlarged digits.

Your child’s doctor may recommend some combination of the following surgical procedures:

  • Soft tissue debulking: To help correct width, this procedure involves the surgical removal of the thickened layers of skin and fat and the replacement of skin with skin grafts harvested from healthy skin in a nearby area. This procedure is usually performed in several stages around three months apart. It’s more often used to treat the milder forms of macrodactyly or as a part of the treatment of the more progressive forms.
  • Shortening procedures: To help correct length, shortening procedures usually involve either surgical removal of one of the phalanges of the finger or toe, or removal of a metacarpal (hand bone) or metatarsal (foot bone).
  • Ray resection: Surgical removal of the entire digit or digits is sometimes necessary, particularly when the condition is progressive. It is also an option if there is excessive widening of the forefoot, where the digital shortening and debulking procedures may not be effective.

What is the long-term outlook for my child?

The long-term outlook for a child treated for macrodactyly varies from child to child, depending on how severe his problem is. You and your child can expect an overall improvement in appearance and function. However, it’s rare that a child’s affected digits look and move perfectly.