Baek G H, Chung M S
Department of Orthopaedic Surgery, Seoul National University College of Medicine, Korea.
J Bone Joint Surg Br. 1998 Nov;80(6):1040-4. doi: 10.1302/0301-620x.80b6.8701.
We performed one-stage lengthening using intercalary autogenous bone graft in 34 metatarsals and seven proximal phalanges in 21 patients with congenitally short metatarsals. At operation, in order to decrease the tension in the surrounding soft tissues, we gradually distracted the osteotomies of the affected bones for 20 to 30 minutes. The patients, all women, were followed up for a mean period of 2.1 years (1 to 6.5). The average gain in length for the 34 metatarsal procedures was 14 mm (6 to 21), equivalent to an increase of 32% (11 to 51), and for the seven proximal phalangeal lengthenings 8 mm (5 to 11), an increase of 54% (47 to 65). There was no evidence of neurovascular impairment. The technique of gradual distraction during operation is simple and effective. It overcomes the disadvantages of one-stage lengthening such as a small gain in length and neurovascular damage.
我们对21例先天性跖骨短小患者的34根跖骨和7根近节趾骨采用一期带蒂自体骨移植延长术。手术时，为降低周围软组织的张力，我们对患骨截骨处进行了20至30分钟的逐渐牵张。患者均为女性，平均随访2.1年（1至6.5年）。34例跖骨手术的平均延长长度为14毫米（6至21毫米），相当于增长了32%（11%至51%）；7例近节趾骨延长手术的平均延长长度为8毫米（5至11毫米），增长了54%（47%至65%）。没有神经血管损伤的迹象。术中逐渐牵张技术简单有效。它克服了一期延长术的缺点，如延长长度小和神经血管损伤。
