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Foot gigantism in children: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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ICD-10 code
Q87.3 Syndromes of congenital anomalies, manifested by excessive growth (gigantism) in the early stages of development.
Symptoms of gigantism of feet
Depending on the type of deformation, five variants of gigantism of feet in children are distinguished: gigantism of the entire foot, internal, middle, outer parts and macrodactyly.
Treatment of gigantism of feet
Treatment of deformities of the lower extremities in patients with gigantism is an extremely complex and little-developed problem.
Non-drug treatment
Conservative treatment of congenital gigantism of feet in children is ineffective.
Surgery
Different methods are used depending on the type of deformation. The optimal age for surgery is 6 months.
With the total increase in the entire foot in young children, the following interventions are shown: epiphysiodez of the metatarsal areas of metatarsal bones in combination with their periectectomy and excision of the interosseous muscles to eliminate soft-tissue obstructions to constriction of the transverse arch of the foot. Approximated rays are fixed with a tendon autograft, cut from long extensors of II-III fingers, which traverses metatarsal bones in the form of an eight, and firmly fixed with a nylon thread.
With a total increase in the entire foot, when it reaches a disfiguring size, the forced exarticulation of one or two of the most enlarged middle rays with a wedge-shaped resection of the tarsi bones is indicated. Fixation is performed by osteosynthesis with an autograft implanted into adjacent metatarsal bones and Kirschner's spokes. Produce an epiphysiode of the remaining metatarsal bones and phalanges of the fingers, defatization and skin plasty.
With an isolated increase in one or more rays of the inner, middle, or outer divisions, multi-stage operations are performed. The first stage is the excision of one of the most enlarged rays with a wedge resection of the foot bones at the level of the middle department. The second and subsequent stages are shortening modeling resections of phalanges of the fingers and metatarsal bones, aimed at reducing the longitudinal size of the foot, as well as longitudinal resection of the phalanges of the fingers and metatarsal bones, aimed at reducing the transverse size of the foot.
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