Macrodystrophy is a rare congenital malformation characterized by hypertrophy of the soft tissues (including subcutaneous fat, tendons, nerves, fatty tubes, etc.) and bones of the fingers or toes. The total incidence is about 1/18,000, with the middle finger being the most common, followed by the index finger, and the second and third toes being the most common. It can occur in a single finger or toe, or in multiple fingers or toes at the same time; it can occur as a single disease or in association with other diseases; it can be combined with syndactyly and oblique toe deformity. There is no significant difference between males and females, and there is no obvious family clustering or dominant or recessive genetic characteristics. Therefore, many parents are concerned about whether the disease will be passed on to the next generation, but there is no clear evidence that it is hereditary. There is no clear evidence of inheritance. The former is characterized by lipoma-like changes in the proliferating tissue without obvious nerve thickening, while the latter is characterized by significant thickening of the involved nerves. Depending on the rate of progression, the disease can be divided into the stationary and progressive types. The progressive form of megalodactyly usually requires early surgical intervention. There are no uniform treatment guidelines for acromegaly, and individualized measures should be developed for each patient. The principle of surgery is to repair the shape and function of the diseased limb and to control the progression of the disease. Treatment methods include soft tissue resection, longitudinal or wedge osteotomy, epiphyseal block, joint fusion, etc. In severe cases, finger (toe) amputation is feasible. At the same time, we do not advocate finger (toe) amputation, but can preserve the fingers and toes as much as possible through reconstructive surgery, so as not to leave irreparable regrets to parents or children. Parents and patients must be very interested in knowing why they have this disease, and they often ask why our children have it when we are not sick as a couple. I have been working on the pathogenesis of megalodactyly for many years and have made some progress. Because of the intellectual property rights involved, what I can tell you now is that there is a protein overexpressed in megalodactyly that is more than 30 times higher than normal, which stimulates cell proliferation and promotes the nervous system and bone development. There is also a mutation in a gene that leads to enhanced activity of this gene, which inhibits apoptosis and promotes tissue growth, leading to the development of megalodontia. I hope that my research results will bring benefits to all patients as soon as possible. The Department of Plastic and Reconstructive Surgery of the Ninth Hospital is a national key discipline, a key discipline of the 211 project of the Ministry of Education, and ranked first in the nation in plastic surgery. Our hand surgery group focuses on the clinical treatment and scientific research of hand and foot deformities. We utilize and take advantage of the advantages of plastic surgery, through local flap delicate design, nerve micro fine anastomosis, micro power precise osteotomy, skin incision exquisite suture, plus a set of post-operative anti-scar measures, so as to maximize the affected patients to obtain the maximum degree of dual improvement of appearance and function. At present, we perform 4-5 giant finger (toe) surgeries every month, and have become one of the largest treatment centers for giant finger (toe) disease in China. Of course, we don’t look at advertisements to see the efficacy. Here are some examples of our cases. Case 1, Yang#, male, 7 years old, right index finger megalodactyly with oblique finger and hypertrophy of the greater interfoveal area. A,B preoperatively; C red arrow indicates right index finger with distal segmental obliquity; D red arrow indicates intraoperative significant thickening of finger nerve seen; E,F immediate postoperative appearance. This patient underwent massive fat removal from the greater interphalangeal area and the index finger, partial osteotomy of the middle and distal phalanges of the index finger and fusion of the distal interphalangeal joint, and steel nail fixation to maintain the finger in the straight position. Case 2, Deng#, female, 23 years old, right thumb with megaloplasia with oblique finger and greater interphalangeal hypertrophy. A,B Preoperatively, the interphalangeal joint of the index finger was already stiff and immobile due to age and long duration of disease; C red arrows indicate reactive hyperplasia of the right index finger and joint with destruction of the articular surface; D red arrows indicate abnormal intraoperative thickening of the finger nerve with fatty infiltration and neuroma-like changes, like egg yolk; E,F immediate postoperative appearance. This patient underwent extensive fat removal, partial osteotomy and interphalangeal fusion of the proximal middle phalanx of the index finger, and steel nail fixation to maintain the finger in the straight position. Neuroma excision and partial nerve anastomosis were also performed; reduction of the widened thumb and fingernail of the index finger was also performed. Case 3, Jiang##, male, 3 years old, right index middle finger megalopsia with oblique finger. A,B preoperatively; C red arrow indicates radial deviation of the right index finger proximal phalanx; D red arrow indicates moderate intraoperative thickening of the finger nerve; E,F immediate postoperative appearance. This patient underwent extensive fat removal (see Figure C), subepiphyseal osteotomy of the proximal phalanx of the index finger, and steel nail fixation to maintain the finger in the straight position. Partial excision and anastomosis of the nerve was also performed; a partial reduction of the widened index finger nail was also performed. Case 4, Tang ##, male, 11 years old, was well controlled after 5 surgeries, and the shape and function of the finger were not different from normal. Can you tell which fingers are diseased? Case 5, do you want your child to develop to this extent? At this point, there is nothing the gods can do. That’s why we advocate early surgery. In order to meet the requests of parents or patients, a new case of megalodon is added (in fact, the surgical method is similar to that of megalodon). Case 6, Hu##, male, 11 months, megalodontia with incomplete syndactyly of the 2nd and 3rd toes of the right foot; megalodontia of the 2nd toe of the left foot. Preoperative: immediate postoperative.