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December 1994

Pictures of the MonthCase 1

Arch Pediatr Adolesc Med. 1994;148(12):1309-1310. doi:10.1001/archpedi.1994.02170120071012

A newborn female with an uncomplicated prenatal course was noted to have abnormalities on the hand and feet (Figure 1 and Figure 2). The results of the remainder of the physical examination were normal, and the family history was without similar abnormalities.

Denouement and Discussion 

Congenital Macrodactyly 

MANIFESTATIONS  Congenital macrodactyly is an uncommon anomaly present at birth characterized by disproportionate enlargement of one or more digits of a hand or foot.1,2 The digit may continue to increase in size as the child grows and it may assume tremendous proportions. The metacarpal and metatarsal bones are generally not involved.1,3 In blacks, congenital macrodactyly usually involves the toes, and in whites, the fingers are predominantly affected.4Congenital macrodactyly may represent true macrodactyly or pseudomacrodactyly. In true congenital macrodactyly, all of thesoft tissues, including tendons, nerves, blood vessels, nails, skin, subcutaneous tissue, and bones of the affected digit, are enlarged.