Barik Sitanshu, Farr Sebastian
Pediatric Orthopedic Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
Orthopedic Hospital Speising, Department of Pediatric Orthopaedics and Adult Foot and Ankle Surgery, Vienna, Austria.
EFORT Open Rev. 2021 Jan 4;6(1):15-23. doi: 10.1302/2058-5241.6.200087. eCollection 2021 Jan.
Brachymetacarpia and brachymetatarsia are rare congenital presentations denoted by shortening of metacarpals and metatarsals respectively, in which the deformity usually presents around childhood/early adolescence.The aetiology is usually congenital besides several other syndromic or endocrinologic associations.Cosmetic issues such as absence of a normal-looking knuckle while making a fist or disruption of finger-tip curvature besides functional issues are the main indications for surgical intervention in brachymetacarpia.In the foot, apart from cosmetic issues, pain due to transfer metatarsalgia as well as callosities along with toe deformities which lead to difficulty of using footwear are the main indications for intervention.Lengthening of the affected bone, either acute with grafting or gradual, is the mainstay of treatment. Gradual lengthening can be either single-stage as in callotasis, or two-stage where the primary procedure is followed by bone grafting after the length has been achieved.Adolescence, specifically between 12 and 15 years, is the preferred period for surgical intervention in these cases. Cite this article: 2021;6:15-23. DOI: 10.1302/2058-5241.6.200087.
短掌骨和短跖骨是罕见的先天性表现，分别表现为掌骨和跖骨缩短，畸形通常出现在儿童期/青春期早期。除了一些其他综合征或内分泌相关因素外，病因通常为先天性。在短掌骨中，手术干预的主要指征包括握拳时外观正常的指关节缺失等美容问题以及指尖弯曲异常等功能问题。在足部，除美容问题外，转移性跖骨痛引起的疼痛、胼胝以及导致穿鞋困难的脚趾畸形是干预的主要指征。对受累骨骼进行延长，无论是采用植骨的急性延长还是逐渐延长，都是主要的治疗方法。逐渐延长可以是如骨痂延长术那样的单阶段延长，也可以是两阶段延长，即先进行初步手术，在达到所需长度后再进行骨移植。青春期，特别是12至15岁之间，是这些病例手术干预的首选时期。引用本文：2021;6:15 - 23。DOI: 10.1302/2058 - 5241.6.200087。
