Steedman J T, Peterson H A
Department of Orthopedics, Mayo Clinic Rochester, Minnesota 55905.
J Pediatr Orthop. 1992 Nov-Dec;12(6):780-5. doi: 10.1097/01241398-199211000-00015.
The first metatarsal of six feet in four patients was surgically lengthened. Brachymetatarsia was caused by a congenital defect in two patients, nonunion after metatarsal osteotomy in one patient, and premature physeal closure associated with pin placement across the physis in one patient. In each patient, middiaphyseal osteotomy was performed, pins were placed into the proximal and distal metatarsal fragments, and an external distracting device was attached. After distraction, a fibular graft was inserted and the device was removed. The percentage of metatarsal length gained from the lengthening averaged 36% (range 12-68%). The fibular graft healed in the lengthened position in all patients.
4例患者的6只脚的第一跖骨接受了手术延长。2例患者的短跖骨是由先天性缺陷引起，1例患者是跖骨截骨术后骨不连，1例患者是与穿过骨骺的钢针置入相关的骨骺过早闭合。在每例患者中，均进行了骨干中段截骨，将钢针置入跖骨近端和远端骨折块，并连接外固定牵张装置。牵张后，植入腓骨移植物并移除该装置。延长后跖骨长度增加的平均百分比为36%（范围为12% - 68%）。所有患者的腓骨移植物均在延长位置愈合。
