Department of Plastic and Reconstructive Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
Department of Plastic and Reconstructive Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
J Foot Ankle Surg. 2021 Nov-Dec;60(6):1293-1296. doi: 10.1053/j.jfas.2021.03.018. Epub 2021 Jun 19.
Gradual lengthening by distraction osteogenesis is widely used for congenital brachymetatarsia. The usual presenting complaint is the patient's cosmetic appearance. Osteotomy is an integral element. A nonincisional surgical approach for osteotomy can reduce dorsal longitudinal scarring and help preserve the periosteal blood supply to the bone during surgical dissection. Between June 2003 and January 2019, we performed gradual lengthening by callus distraction with nonincisional osteotomy for congenital brachymetatarsia on 13 digits in 5 patients. All 5 patients were female, and their average age was 18 years old. The lengthened bones involved 3 first metatarsals, 2 third metatarsal, and 8 fourth metatarsal bones. The mean gain in length was 15.2 mm (10-21 mm). The mean duration of distraction was 36.2 days (30-48 days). The mean duration of consolidation was 62.8 days (28-103 days). The lengthened segment consolidated in all cases. One patient had early consolidation and did not wish to undergo further surgery. There were no cases of trouble due to drilling for osteotomy. All patients had a normal gait and were satisfied with the cosmetic results.
骨痂牵伸逐渐延长术广泛应用于先天性短趾畸形。常见的就诊主诉是患者的外观问题。截骨术是一个必不可少的元素。非切开手术入路进行截骨术可以减少背侧纵向瘢痕，并有助于在手术解剖过程中保持骨膜的血供。2003 年 6 月至 2019 年 1 月，我们对 5 例患者的 13 个趾骨采用骨痂牵伸非切开截骨术进行了先天性短趾畸形的逐渐延长术。所有 5 例患者均为女性，平均年龄 18 岁。延长的骨骼涉及 3 个跖骨、2 个第 3 跖骨和 8 个第 4 跖骨。平均延长长度为 15.2mm（10-21mm）。平均牵伸时间为 36.2 天（30-48 天）。平均骨愈合时间为 62.8 天（28-103 天）。所有延长段均愈合。1 例患者早期愈合，不愿再接受手术。无因钻孔截骨而出现问题的病例。所有患者行走正常，对美容效果满意。
