1 Module of Politrauma, Reconstruction and External Fixation, Department of Orthopaedics and Traumatology, University Hospital "Dr. José Eleuterio González," Universidad Autónoma de Nuevo Leon, Monterrey, Nuevo León, México.
Foot Ankle Int. 2018 Aug;39(8):942-948. doi: 10.1177/1071100718770388. Epub 2018 Apr 11.
Brachymetatarsia is a rare foot deformity caused by the premature closure of the metatarsal physis. It may result in functional as well as cosmetic alterations, which may require operative management.
A prospective study examining outcomes of 48 cases of brachymetatarsia with gradual bone lengthening at a rate of 1 mm/d using an external fixator and metatarsophalangeal joint fixation was performed. The difference between the length before treatment and after external fixator removal was measured. The patients were assessed at 2, 4, 6, and 8 weeks postoperatively; at the end of the period of distraction; and 1 year after surgery. The total number of patients was 26, and surgery was performed in 48 metatarsals. The mean age was 17.0 ± 4.1 (range, 11-24) years, and all were female.
The fourth metatarsal was the most frequently affected, representing 98% of the cases; the third metatarsal represented the other 2%. The average length gained was 18.6 ± 6.7 mm, and the average length gained as a proportion of the original metatarsal length was 38.2% ± 3.1% (range, 13%-24%). The mean healing time was 71.0 (range, 64-104) days, and the mean healing index (healing time divided by centimeters of length gained [d/cm]) was 38.4 (range, 38.2-50.1) d/cm.
Gradual bone lengthening at a rate of 1 mm/d using an external fixator and intramedullary nailing was a safe and efficient method, representing a minimally invasive procedure with a low incidence of complications and satisfactory results for the patient.
Level IV, retrospective case series.
短趾畸形是一种罕见的足部畸形，由跖骨干骺端过早闭合引起。它可能导致功能和美容改变，这可能需要手术治疗。
对 48 例使用外固定架和跖趾关节固定进行逐渐骨延长（每天 1 毫米）的短趾畸形患者进行前瞻性研究。测量治疗前和外固定架去除后的长度差异。术后 2、4、6 和 8 周、延长期结束以及术后 1 年对患者进行评估。总共有 26 例患者，48 个跖骨接受了手术。平均年龄为 17.0 ± 4.1（范围 11-24）岁，均为女性。
第四跖骨是最常受累的，占 98%；第三跖骨占 2%。平均增加长度为 18.6 ± 6.7 毫米，平均增加长度占原始跖骨长度的 38.2%±3.1%（范围 13%-24%）。平均愈合时间为 71.0（范围 64-104）天，平均愈合指数（愈合时间除以厘米增加长度[d/cm]）为 38.4（范围 38.2-50.1）d/cm。
使用外固定架和髓内钉每天 1 毫米逐渐骨延长是一种安全有效的方法，是一种微创程序，并发症发生率低，患者结果满意。
四级，回顾性病例系列。
