Macrodactyly of the Hand Managed with Digital Shortening and Nail Bed Grafting

Abstract

Macrodactyly is a rare congenital condition in which one or more digits grow disproportionately due to overgrowth of bone, soft tissue, and nerves. We report a 31-year-old woman with progressive enlargement of the long and ring fingers of her right hand, causing pain, limited flexion of the long finger, and cosmetic concern. Examination revealed disproportionate digit size, clinodactyly of the long finger, intact sensation, and normal vascularity. Imaging confirmed hypertrophy of bone and soft tissues, with enlargement of the median and digital nerves. The patient underwent digital shortening of the long finger at the distal interphalangeal joint, excision of fibro-fatty tissue, and nail bed grafting, preserving neurovascular structures. At six months, the nail bed graft had fully taken, digit size was reduced, clinodactyly corrected, sensation and circulation preserved, pain resolved, and hand function improved. The patient was satisfied, and no recurrence was observed.