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如何避免第一跖骨短小症牵张成骨的并发症。

How to avoid complications of distraction osteogenesis for first brachymetatarsia.

作者信息

Lee Keun-Bae, Yang Hyun-Kee, Chung Jae-Yoon, Moon Eun-Sun, Jung Sung-Taek

机构信息

Department of Orthopaedics, Chonnam National University Medical School and Hospital, Gwangju, South Korea.

出版信息

Acta Orthop. 2009 Apr;80(2):220-5. doi: 10.3109/17453670902930040.

DOI:10.3109/17453670902930040
PMID:19404807
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2823162/
Abstract

BACKGROUND AND PURPOSE

Distraction osteogenesis may be used for the treatment of brachymetatarsia. However, few reports have been published on first metatarsal lengthening by this method. We evaluated the complications of distraction osteogenesis for first brachymetatarsia and here we provide a solution.

PATIENTS AND METHODS

16 patients (27 feet) underwent distraction osteogenesis for first brachymetatarsia. Mean age at time of surgery was 20 (12-34) years and mean duration of postoperative follow-up was 5 (2-13) years. A unilateral external fixator was fixed at the medial aspect of the metatarsus. The distraction axis was parallel to the plantar surface of the foot in the sagittal plane and to the second metatarsal axis in the transversal plane.

RESULTS

First metatarsal length expressed as a proportion of second metatarsal length was 60% (55-64). Average degree of metatarsal lengthening was 42% (34-54), and the average lengthening index was 64 (39-93) days/cm. The most common complication was stiffness of the metatarsophalangeal joint (12 feet). Deformities that included cavus foot and hallux valgus occurred in 3 feet each, and callus fractures occurred in 3 feet. The other complications were pin breakage and pin tract infection in 2 feet each.

INTERPRETATION

Distraction osteogenesis for first brachymetatarsia can give satisfactory cosmetic and functional results. However, several complications are commonly encountered. This report on complications and their solutions may help those attempting distraction osteogenesis for first brachymetatarsia.

摘要

背景与目的

牵张成骨术可用于治疗短跖骨。然而，关于采用这种方法进行第一跖骨延长的报道很少。我们评估了第一短跖骨牵张成骨术的并发症，并在此提供一种解决方案。

患者与方法

16例患者（27足）接受了第一短跖骨牵张成骨术。手术时的平均年龄为20（12 - 34）岁，术后平均随访时间为5（2 - 13）年。在跖骨内侧固定单侧外固定器。牵张轴在矢状面与足底平行，在横断面与第二跖骨轴平行。

结果

第一跖骨长度与第二跖骨长度的比例为60%（55 - 64）。跖骨平均延长程度为42%（34 - 54），平均延长指数为64（39 - 93）天/厘米。最常见的并发症是跖趾关节僵硬（12足）。包括高弓足和拇外翻在内的畸形各发生在3足，骨痂骨折发生在3足。其他并发症为针折断和针道感染，各发生在2足。

解读

第一短跖骨牵张成骨术可获得满意的外观和功能效果。然而，常见几种并发症。这份关于并发症及其解决方案的报告可能有助于那些尝试对第一短跖骨进行牵张成骨术的人。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f1c/2823162/2357201e124b/ORT-1745-3674-80-220-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f1c/2823162/fa9734e3ad4e/ORT-1745-3674-80-220-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f1c/2823162/90010cc7f4f7/ORT-1745-3674-80-220-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f1c/2823162/4cce4687018c/ORT-1745-3674-80-220-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f1c/2823162/2357201e124b/ORT-1745-3674-80-220-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f1c/2823162/fa9734e3ad4e/ORT-1745-3674-80-220-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f1c/2823162/90010cc7f4f7/ORT-1745-3674-80-220-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f1c/2823162/4cce4687018c/ORT-1745-3674-80-220-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f1c/2823162/2357201e124b/ORT-1745-3674-80-220-g004.jpg

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