Surgical Management of Pediatric Foot Macrodactyly: A Case Series Highlighting Variable Growth Patterns and Soft-Tissue Challenges
Year: 2026
Type: article
Study design: Case Report
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.
Source: Cureus
Institutions: Osaka Metropolitan University, Osaka City General Hospital
Language: English
Subfield: Developmental Biology
Domain: Life Sciences
Open Access status: diamond
OpenAlex ID: W7220404780