Updated: 10/11/2016

Local Gigantism

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https://upload.orthobullets.com/topic/4083/images/local_gigantism_moved.jpg
Introduction
  • Overview
    • form of gigantism usually isolated to fingers or toes "macrodactyly" but may affect an entire limb
  • Epidemiology & Incidence
    • rare
    • congenital causes:
      • neurofibromatosis
      • proteus syndrome
      • klippel-Trenaunay-Weber
    •  acquired causes:
      • amyloidosis
      • elephantiasis (filariasis)
      • av malformation
      • tumor
      • acromegaly
  • Physiology
    • unknown
Relevant Anatomy
  • Growth plate consists of three principal layers:
    • resting zone
    • proliferative zone
    • hypertrophic zone
Presentation
  • Symptoms
    • pain
  • Physical exam
    • enlarged digit or limb
Imaging
  • Radiograhs
    • needed for reconstruction or amputation planning
Treatment
  • Nonoperative
    • observation
      • monitor growth of affected region
  • Operative
    • epiphysiodesis vs. bony and soft-tissue reduction procedures
      • indications
        • individualized based on etiology, location of affected area, skeletal growth left, and severity
    • amputation
 

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