Orthopedics - Oleksa A.P. 2006

Congenital and Acquired Defects of the Lower Extremity
Orthopedic Foot Deformities
Congenital Gigantism of the Toes

Congenital Macrodactyly of the toe is caused by its accelerated growth resulting from excessive tissue proliferation.

Congenital macrodactyly may affect one or more toes, but it most frequently involves the first or second toe (Fig. 200). In congenital partial macrodactyly of a toe, surgical intervention is necessary because the enlarged digit makes it difficult to wear normal footwear and presents a cosmetic deformity.

The surgery consists in the removal of excess tissue under general anesthesia or regional block using a 1% novocain solution. In cases of pronounced toe macrodactyly, a digit of normal size must be reconstructed. For this purpose, resection of the proximal phalanx of the hallux or removal of the middle phalanx of another toe is performed, along with simultaneous excision of the excess soft Tissues. During the operation, it is essential to avoid vascular damage and to preserve a reduced nail matrix after partial excision. Amputation of the distal part of the toe for shortening is discouraged, as the absence of the distal phalanx and nail constitutes a cosmetic defect.