RESUMO
We report our experience in seven patients with congenital gigantism of the foot with the following diagnoses: neurofibromatosis (two), fibrolipomatosis (two), Proteus syndrome (two), and idiopathic localized gigantism (one). Our purpose is to introduce a new classification of foot gigantism, based on the concept of "neuroinduction." In our experience, intraoperative examination and subsequent histologic examination show consistently pathologic findings in the plantar nerve and its terminal branches in the foot affected by gigantism. Limited surgical treatment was used in five patients. To prevent forefoot enlargement and recurrence of deformity, we suggest complete ray resection. We evaluated our results using radiographs, functional status, and cosmetic considerations.
Assuntos
Deformidades Congênitas do Pé/cirurgia , Gigantismo/cirurgia , Adulto , Criança , Pré-Escolar , Estética , Feminino , Deformidades Congênitas do Pé/diagnóstico por imagem , Deformidades Congênitas do Pé/fisiopatologia , Gigantismo/diagnóstico por imagem , Gigantismo/fisiopatologia , Humanos , Lactente , Recém-Nascido , Lipomatose/diagnóstico por imagem , Lipomatose/cirurgia , Masculino , Neurofibromatoses/diagnóstico por imagem , Neurofibromatoses/cirurgia , Síndrome de Proteu/diagnóstico por imagem , Síndrome de Proteu/cirurgia , Radiografia , Resultado do TratamentoRESUMO
A case of macrodactyly of the foot associated with plexiform neurofibroma of the digital branches of the medial plantar nerve is reported. The purpose of this article is to investigate the nature of the association of the rare localization of macrodactyly with a pathognomonic feature of von Recklinghausen disease. The case was approached by semiconservative surgical treatment. Two-year follow-up has shown no relapse of the deformity. These facts suggest that this case of macrodactyly was sustained by an underlying disorder, namely, a "forme fruste" of neurofibromatosis, implying the existence of a still unknown pathogenetic mechanism.
