Big finger (toe)

Introduction Giant finger (toe) is a congenital malformation characterized by an increase in the volume of the fingers or toes. The incidence in congenital malformations of the extremities is very low, about 0.9%. Men are slightly more than women, and heredity is not obvious. The clinical manifestations are skin, subcutaneous tissue, finger phalanx, nerves, vasculature, tendons and even muscles, and the nails are overgrown and hypertrophied compared with normal fingers and toes. Its growth stops after the basic development of the whole body (the boy is about 8 years old, the girl is about 16 years old). The small range of the giant finger (toe) only affects the single finger (toe), the incidence is more, and the large one can affect one limb.

Cause

The pathogenesis of giant finger (toe) is still under study and no conclusion has been reached. This disease is associated with multiple neurofibromatosis. It is believed that multiple neurofibromas of the periosteal nerve cause bone destruction and regeneration, and that multiple neurofibromas are the only cause of localized rapid growth. However, 13 patients were reported, none of which had clinical or histological features of multiple neurofibromas. Therefore, in order to link the two, the "incomplete multiple neurofibromatosis" is used to define the giant finger deformity.

an examination

Related inspection

CT examination of bone and joint and soft tissue toe dorsiflexion test

Giant finger (toe) disease usually occurs after birth, while other fingers or toes are normal. It can be seen that one or a few fingers increase significantly, but not all fingers are involved. Cases of localized hypertrophy have been reported, and the damage only affects the distal end of the finger. The giant finger grows with the growth and development of the child, and its speed is different. Since the lesion is mostly located on one side of the finger, in addition to seeing the entire finger being large, the common side is overgrown and the finger is curved to the side to be skewed laterally. The lesion is characterized by the proliferation of bone and fat. The giant finger not only affects the shape of the hand, but also affects the function. If the enlarged lesion is located in the carpal tunnel, there will be symptoms of nerve compression.

Differential diagnosis

Clubbing (toe): The soft tissue at the end of the finger (toe) is thickened like a drum, and has an arched bulge. The longitudinal ridges and transverse ridges are highly curved, and the surface is glassy. It is called a snappy.clubbing finger ). Also known as the faded finger. The angle between the side nail and the nail skin of the healthy person's finger is 160 degrees. With the occurrence of the forest finger, the angle can be gradually increased to 180 degrees or more. Pressing the root of the nail can have a noticeable elasticity and tenderness. The finger-like fingers appearing in different diseases have different fingertip colors. The forest finger of the congenital heart disease of the hair group, the finger is often purple and black, the nail arc is reddish brown, the capillary of the nail bed is increased, and the blood flow at the finger end is increased. In patients with lung disease, the fingertips of the forest finger are dry and not smooth, yellowish white, and the blood vessel proliferation is not significant. Oral refers to the more common symptoms of certain diseases in the internal medicine.

Spoon finger (toe): clinical manifestations of Plummer-Vinson syndrome, the main clinical manifestations of dysphagia, pharyngeal foreign body sensation, intermittent dysphagia, without pain, often developed into persistence. More common iron deficiency anemia performance, such as loss of appetite, fatigue, palpitations, pale, spoon finger (toe) and hair loss. Also often accompanied by angular cheilitis, glossitis, smooth tongue, atrophy, nipple disappeared. In most patients, X-ray and esophagoscopy revealed a diaphragm-type mucosal diaphragm in the lower part of the throat and upper part of the esophagus. Almost all of the laboratory tests have iron deficiency anemia, serum iron concentration is significantly reduced, and some have pernicious anemia.

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