Pang CJ, Huo XY, Liu Y, Yang ZY, Liu L, Fan XB, Xu SW. Surgical management of adult hand macrodactyly in a 49-year-old patient: A case report. World J Clin Cases 2024; 12(22): 5236-5244 [DOI: 10.12998/wjcc.v12.i22.5236]
Corresponding Author of This Article
Chao-Jian Pang, MD, Surgeon, Department of Orthopaedic Surgery, The First Hospital of Handan, No. 25 Congtai Road, Handan 050000, Hebei Province, China. pangchaojian@163.com
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Chao-Jian Pang, Xiao-Yan Huo, Yuan Liu, Xiao-Bo Fan, Department of Orthopaedic Surgery, The First Hospital of Handan, Handan 050000, Hebei Province, China
Zong-You Yang, Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
Lu Liu, Department of Health Management, Hebei Provincial Hospital of Traditional Chinese Medicine, Shijiazhuang 050000, Hebei Province, China
Shang-Wen Xu, Department of Hand Surgery, The First Hospital of Handan, Handan 050000, Hebei Province, China
Author contributions: Pang CJ, Huo XY and Yang ZY contributed to manuscript writing and editing, and data collection; Liu Y, Liu L, Fan XB and Xu SW contributed to conceptualization and supervision of the study; All authors have read and approved the final manuscript.
Supported bySpecial TCM Innovation Project of Hebei Provincial Department of Science and Technology, No. 223777130D; and Scientific Research Project of Hebei Province Administration of Traditional Chinese Medicine, No. 2024215.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chao-Jian Pang, MD, Surgeon, Department of Orthopaedic Surgery, The First Hospital of Handan, No. 25 Congtai Road, Handan 050000, Hebei Province, China. pangchaojian@163.com
Received: April 14, 2024 Revised: May 20, 2024 Accepted: June 14, 2024 Published online: August 6, 2024 Processing time: 78 Days and 17.5 Hours
Abstract
BACKGROUND
Macrodactyly is a rare congenital malformation characterized by an increase in the size of all structures of a digit, accounting for less than 1% of all congenital upper extremity conditions.
CASE SUMMARY
We report a case involving a 49-year-old woman who presented for the first time with untreated, radial-sided hand macrodactyly. We performed soft tissue debulking, amputation, median nerve neurotomy and coaptation, and carpal tunnel release. At the 6-year follow-up, no significant growth was observed in the bone or soft tissue of the affected area.
CONCLUSION
Tissue overgrowth in patients with progressive macrodactyly can continue and progress excessively with age. Median nerve neurotomy and coaptation play a crucial role in preventing recurrence of the deformity.
Core Tip: Macrodactyly is a rare congenital malformation, constituting less than 1% of congenital upper extremity anomalies. It typically involves enlarged structures of a digit, often managed through various surgical methods including tissue reduction and nerve adjustments. As first suggested by Tsuge, hypertrophic nerves are thought to drive the overgrowth. The condition is often associated with adipose lesions categorized as intraneural or extraneural lipomas and lipomatosis of the nerve, frequently affecting the median nerve. Managing and preventing recurrence remains a clinical challenge, especially in adults.
