Complications of Distraction Osteogenesis in Short First Metatarsals

Oh, Chang Wug; Satish, Bhava R.J.; Lee, Sung-Tae; Song, Hae-Ryong

doi:10.1097/00004694-200411000-00021

Cited by 14 publications

(13 citation statements)

References 14 publications

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“…Our healing index for metatarsal lengthening is greater than the healing index reported by other authors [16,19]. We feel that these results are due to a greater amount of lengthening (average lengthening of 24.3 mm) achieved in our study compared with others (average lengthening not less than 17.6 mm) [4,12,17].…”

Section: Discussioncontrasting

confidence: 58%

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Lengthening of short bones by distraction osteogenesis—results and complications

Erdem

Şen

Eralp

et al. 2007

International Orthopaedics (SICOT)

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We performed bone lengthening surgery on 12 metacarpals and 14 metatarsals of 15 patients. The mean age for metacarpal and metatarsal lengthening was 14.5 (10-21) and 17.5 (10-25) years, respectively. We used a unilateral or a circular external fixator. The mean healing index of the metacarpals and metatarsals was 1.6 (1.1-2.3) and 1.6 (1.0-2.0) months/cm, respectively. The mean increase in metacarpal and metatarsal length was 17.6 (13-26) and 24.3 (20-30) mm, respectively. The functional scores of the metatarso-phalangial (MTP) joint of lengthened metatarsals for the lesser toe were excellent in 12 and good in two cases based on the American Orthopaedic Foot and Ankle Society (AOFAS) scoring system. Complications were seen in six of the metatarsal lengthening cases including four angulations, one subluxation and one non-union. We conclude that the periosteum must be protected with percutaneous osteotomy and lengthening should be performed at a rate of 0.25 mm twice a day and should not exceed 40% of the original bone length (or >20 mm).Résumé Nous avons réalisé une chirurgie d'allongement sur 12 métacarpiens et 14 métatarsiens chez 15 patients.

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Section: Discussioncontrasting

confidence: 58%

“…Many authors reported that a healing index of less than 1.5 months/cm could be achieved by applying an extension rhythm of 0.25 mm twice a day [4,12,17]. A healing index Fig.…”

Section: Discussionmentioning

confidence: 99%

Lengthening of short bones by distraction osteogenesis—results and complications

Erdem

Şen

Eralp

et al. 2007

International Orthopaedics (SICOT)

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“…stiffness or subluxation of the MTP joint, cavus or other angulation deformity of the metatarsus, prolonged time for bony consolidation, and pin tract infection (Table 2) (Kawashima et al 1994, Takakura et al 1997, Masada et al 1999, Oh et al 2004). …”

Section: Discussionmentioning

confidence: 99%

“…Surgery should be planned on the basis of functional recovery and anatomical restoration that restores proper weight bearing in addition to addressing cosmetic problems. Several techniques have been described for the treatment of brachymetatarsia; these include one-stage lengthening using an interpositional bone graft, gradual lengthening by distraction osteogenesis with or without shortening of the adjacent metatarsals and phalanges, and shortening of adjacent metatarsals and phalanges (Harris and Beath 1949, Hughes et al 1990, Kawashima et al 1994, Choi et al 1999, Masada et al 1999, Oh et al 2004). …”

Section: Introductionmentioning

confidence: 99%

“…The advantages of distraction osteogenesis include: no need for bone grafting, easier tendon stretching, fewer neurovascular complications, early weight bearing, and a larger length gain, whereas disadvantages include stiffness or subluxation of the metatarsophalangeal (MTP) joint, cavus or angulation deformity, pin tract infection, and a longer period of bony union (Kawashima et al 1994, Takakura et al 1997, Choi et al 1999, Masada et al 1999, Oh et al 2004, Shim and Park 2006). However, few reports have been published on first metatarsal lengthening by this method (Takakura et al 1997, Oh et al 2004, Kim et al 2003, Shim and Park 2006). We evaluated the results and complications that occurred in 27 feet with brachymetatarsia of the first ray treated with distraction osteogenesis, and here we provide solutions for complications.…”

Section: Introductionmentioning

confidence: 99%

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How to avoid complications of distraction osteogenesis for first brachymetatarsia

et al. 2009

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Background and purpose Distraction osteogenesis may be used for the treatment of brachymetatarsia. However, few reports have been published on first metatarsal lengthening by this method. We evaluated the complications of distraction osteogenesis for first brachymetatarsia and here we provide a solution.Patients and methods 16 patients (27 feet) underwent distraction osteogenesis for first brachymetatarsia. Mean age at time of surgery was 20 (12–34) years and mean duration of postoperative follow-up was 5 (2–13) years. A unilateral external fixator was fixed at the medial aspect of the metatarsus. The distraction axis was parallel to the plantar surface of the foot in the sagittal plane and to the second metatarsal axis in the transversal plane.Results First metatarsal length expressed as a proportion of second metatarsal length was 60% (55–64). Average degree of metatarsal lengthening was 42% (34–54), and the average lengthening index was 64 (39–93) days/cm. The most common complication was stiffness of the metatarsophalangeal joint (12 feet). Deformities that included cavus foot and hallux valgus occurred in 3 feet each, and callus fractures occurred in 3 feet. The other complications were pin breakage and pin tract infection in 2 feet each.Interpretation Distraction osteogenesis for first brachymetatarsia can give satisfactory cosmetic and functional results. However, several complications are commonly encountered. This report on complications and their solutions may help those attempting distraction osteogenesis for first brachymetatarsia.

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Distraction osteogenesis of fourth brachymetatarsia

Hosny

Ahmed

2016

Foot and Ankle Surgery

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Complications of Distraction Osteogenesis in Short First Metatarsals

Cited by 14 publications

References 14 publications

Lengthening of short bones by distraction osteogenesis—results and complications

Lengthening of short bones by distraction osteogenesis—results and complications

How to avoid complications of distraction osteogenesis for first brachymetatarsia

Distraction osteogenesis of fourth brachymetatarsia

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