Kawashima T, Yamada A, Ueda K, Harii K
Department of Plastic and Reconstructive Surgery, Takeda General Hospital, Fukushima, Japan.
Ann Plast Surg. 1994 Feb;32(2):191-9. doi: 10.1097/00000637-199402000-00016.
Callus distraction (callotasis) has already become a popular procedure in the lengthening of limbs. With the development of a small device, it can also be applied to the hand or foot, thus providing benefits in the treatment of brachymetatarsia. Four toes of 3 patients with brachymetatarsia of the fourth toe were treated by this method, and excellent elongation of from 17.50 to 32.55 mm (average, 23.71 mm) was acquired. The treatment period ranged from 78 to 141 days (average, 112.5 days). More time was required in the earlier cases, but the most recent took only 11 weeks. The optimal distraction rate is considered to be 0.35 mm per half-day. Reshortening after treatment ranged from 3.6 to 5.5 mm (average, 4.7 mm), or from 15% to 26% (average, 20.5%) of the distracted length. About 90% of the resorption was observed within 1 month, except in a case that involved a postoperative fracture, and no resorption was seen after 2 surgical months. Regarding complications, subluxation of joints was seen in 2 patients and a postoperative fracture in 1 patient. Subluxation was caused by tendons resisting elongation. The procedure is described, representative cases are illustrated, and problems encountered are discussed.
骨痂牵张术（骨痂延长术）已成为肢体延长的常用方法。随着小型器械的发展，该方法也可应用于手或足部，从而为治疗短跖骨提供了益处。采用此方法治疗了3例第四趾短跖骨患者的4根趾骨，趾骨获得了17.50至32.55毫米（平均23.71毫米）的良好延长。治疗周期为78至141天（平均112.5天）。早期病例需要更多时间，但最近的病例仅需11周。最佳牵张速率被认为是每半天0.35毫米。治疗后缩短范围为3.6至5.5毫米（平均4.7毫米），占牵张长度的15%至26%（平均20.5%）。除1例术后骨折病例外，约90%的骨吸收在1个月内观察到，术后2个月未见骨吸收。关于并发症，2例患者出现关节半脱位，1例患者发生术后骨折。半脱位是由肌腱抵抗伸长引起的。本文描述了该手术方法，展示了典型病例，并讨论了遇到的问题。
