Kumar Pradeep, Pillai Anand, Bate Jo-Ann, Henry Joshua
Wythenshawe Hospital, Manchester, UK.
J Surg Case Rep. 2018 Oct 11;2018(10):rjy269. doi: 10.1093/jscr/rjy269. eCollection 2018 Oct.
Brachymetatarsia is a rare forefoot deformity predominantly affecting the fourth metatarsal. Current treatment include gradual lengthening by distraction osteogenesis using an external fixator or single-stage lengthening with bone grafting or a combination of the above two procedures. Our aim was to assess outcomes and complications of a novel technique for gradual metatarsal lengthening using a circular fixator. The procedure was performed on three female patients with unilateral congenital shortening of the fourth ray. All participants reported aesthetic dissatisfaction as well as pressure related complications of the deformity and opted for lengthening and distraction osteogenesis using a frame. Mean duration of the treatment was 122 days and average length gained was 12 mm. The desired metatarsal length was achieved in all three patients with no significant complications. This method of treatment of brachymetatarsia is effective and reproducible. This a promising technique, owing to its low complication rates and efficacy in lengthening.
短跖骨症是一种罕见的前足畸形，主要影响第四跖骨。目前的治疗方法包括使用外固定器通过牵张成骨进行逐渐延长，或采用骨移植进行单阶段延长，或以上两种方法联合使用。我们的目的是评估使用环形固定器进行跖骨逐渐延长的新技术的疗效和并发症。该手术应用于3例单侧先天性第四跖骨短缩的女性患者。所有参与者均表示对外观不满意，且存在与畸形相关的压迫性并发症，并选择使用框架进行延长和牵张成骨。平均治疗时间为122天，平均延长长度为12毫米。所有3例患者均达到了理想的跖骨长度，且无明显并发症。这种治疗短跖骨症的方法有效且可重复。由于其低并发症发生率和延长效果，这是一种很有前景的技术。
