Surgical Management of Pediatric Foot Macrodactyly: A Case Series Highlighting Variable Growth Patterns and Soft-Tissue Challenges
- 1Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, JPN
- 2Department of Pediatric Orthopaedic Surgery, Osaka City General Hospital, Osaka, JPN
- 3Department of Orthopaedic Surgery, Osaka City General Hospital, Osaka, JPN
Abstract
Macrodactyly of the foot is a rare congenital anomaly characterized by disproportionate overgrowth of osseous and soft-tissue structures. Its clinical course varies considerably among patients, and no standardized surgical strategy has been established. We retrospectively reviewed four pediatric patients with foot macrodactyly who underwent surgical treatment at our institutions.
The series included two patients without clinical features suggestive of an associated overgrowth syndrome and two with associated overgrowth syndromes. Surgical procedures were selected according to the extent and progression of the deformity and included epiphysiodesis, phalangectomy, distal toe amputation, ray resection, metatarsal shortening osteotomy, and soft-tissue debulking. One patient showed relatively limited subsequent enlargement after early surgical treatment and required no further surgery, whereas the other patients required additional procedures for progressive or residual deformity. In the two patients with associated overgrowth syndromes, marked soft-tissue hypertrophy remained a major therapeutic challenge despite surgical treatment, including soft-tissue debulking.
These cases demonstrate that surgical management of foot macrodactyly should consider not only growth behavior but also the three-dimensional characteristics of the deformity. Longitudinal and transverse enlargement can be addressed by growth modulation and skeletal procedures, whereas vertical enlargement caused predominantly by soft-tissue hypertrophy may be more difficult to control. A staged and individualized surgical strategy with long-term follow-up is therefore important, particularly in patients with progressive deformity or marked soft-tissue involvement.
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BibTeX
@article{shintani2026surgical,
title = {{Surgical Management of Pediatric Foot Macrodactyly: A Case Series Highlighting Variable Growth Patterns and Soft-Tissue Challenges}},
author = {Kosuke Shintani and Keisuke Nakagawa and Ryo Hosomi and Yuma Onishi and Chinatsu Ohira and Hidetomi Terai},
journal = {Cureus},
year = {2026},
month = oct,
doi = {10.7759/cureus.117508},
url = {https://doi.org/10.7759/cureus.117508},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Surgical Management of Pediatric Foot Macrodactyly: A Case Series Highlighting Variable Growth Patterns and Soft-Tissue Challenges
AU - Kosuke Shintani
AU - Keisuke Nakagawa
AU - Ryo Hosomi
AU - Yuma Onishi
AU - Chinatsu Ohira
AU - Hidetomi Terai
PY - 2026
DA - 2026/10/05
JO - Cureus
DO - 10.7759/cureus.117508
UR - https://doi.org/10.7759/cureus.117508
AB - Macrodactyly of the foot is a rare congenital anomaly characterized by disproportionate overgrowth of osseous and soft-tissue structures. Its clinical course varies considerably among patients, and no standardized surgical strategy has been established. We retrospectively reviewed four pediatric patients with foot macrodactyly who underwent surgical treatment at our institutions. The series included two patients without clinical features suggestive of an associated overgrowth syndrome and two with associated overgrowth syndromes. Surgical procedures were selected according to the extent and progression of the deformity and included epiphysiodesis, phalangectomy, distal toe amputation, ray resection, metatarsal shortening osteotomy, and soft-tissue debulking. One patient showed relatively limited subsequent enlargement after early surgical treatment and required no further surgery, whereas the other patients required additional procedures for progressive or residual deformity. In the two patients with associated overgrowth syndromes, marked soft-tissue hypertrophy remained a major therapeutic challenge despite surgical treatment, including soft-tissue debulking. These cases demonstrate that surgical management of foot macrodactyly should consider not only growth behavior but also the three-dimensional characteristics of the deformity. Longitudinal and transverse enlargement can be addressed by growth modulation and skeletal procedures, whereas vertical enlargement caused predominantly by soft-tissue hypertrophy may be more difficult to control. A staged and individualized surgical strategy with long-term follow-up is therefore important, particularly in patients with progressive deformity or marked soft-tissue involvement.
SN - 2168-8184
ER -