Metatarsal Lengthening in Congenital Brachymetatarsia: One-Stage Lengthening Versus Lengthening by Callotasis

Choi, In Ho; Chung, Moon Sang; Baek, Goo Hyun; Cho, Tae-Joon; Chung, Chin Youb

doi:10.1097/01241398-199909000-00021

Cited by 45 publications

(56 citation statements)

References 9 publications

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“…One-stage metatarsal lengthening by bone interposition was first reported in 1969 by McGlamry and Cooper [22]; many authors treat brachymetatarsia by this method, but the current literature deals only with small series. The use of autologous metatarsal [3,11,14,15,24,26], calcaneal [13,30], tibial [1], and iliac crest [2,6,31] bone graft has been reported, and the major advantages are the short time needed to achieve bone union and the small surgical scar [6,12,14,17,20,32,38]. Despite these advantages, donor site morbidity Fig.…”

Section: Discussionmentioning

confidence: 99%

“…The implant can be removed 1 month after bone healing is radiographically evident and this may take as much as 3 months [28]. The presence of the external fixator, management of the distraction, and frequent redressing can create emotional and psychological problems for the patients [6]. The long time for bone healing, hypertrophic surgical scar, pin tract infections in as much as 21% of cases, premature consolidation of the callus, pain during distraction, callus fracture, stiffness of the metatarsophalangeal joint with decrease in movement, dislocation and subluxation of the metatarsophalangeal joint, toe flexion deformity, and angular and medial deviation of the treated metatarsal have been reported [7,8,17,20,25,32,35,38,39].…”

Section: Discussionmentioning

confidence: 99%

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One-stage Metatarsal Lengthening by Allograft Interposition: A Novel Approach for Congenital Brachymetatarsia

Giannini

Faldini

Pagkrati

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background Congenital brachymetatarsia, a shortened metatarsal bone, can be corrected surgically by callus distraction or one-stage lengthening using bone graft. Questions/purposes We asked whether one-stage metatarsal lengthening using metatarsal homologous bone graft could improve forefoot function, lead to metatarsal healing, restore metatarsal parabola, and improve cosmetic appearance. Patients and MethodsWe retrospectively reviewed 29 patients (41 feet) in whom we lengthened 50 metatarsals. Surgery consisted of a transverse proximal osteotomy of the metatarsal shaft and interposition of a metatarsal homologous bone graft (average, 13 mm long) fixed with an intramedullary Kirschner wire. Minimum followup was 3 years (mean, 5 years; range, 3-11 years). Results Bone union was achieved in all cases. The mean preoperative American Orthopaedic Foot and Ankle Society score was 37 points (range, 28-53 points) and the mean postoperative score was 88 points (range, 74-96 points), with an average improvement of 51 points. Radiographically, the mean gain in length was 13 mm (range, 10-15 mm), and the mean percentage increase was 23%. Conclusions One-stage metatarsal lengthening using interposition of metatarsal homologous bone graft to correct congenital brachymetatarsia has low morbidity for the patient, limited complications, short recovery times, and restores forefoot anatomy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

One-stage Metatarsal Lengthening by Allograft Interposition: A Novel Approach for Congenital Brachymetatarsia

Giannini

Faldini

Pagkrati

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…The most frequently used technique is either one-stage lengthening with an intercalary bone graft or gradual lengthening by callotasis [2,5,18]. One-stage lengthening of metacarpals has several advantages, including a relatively short union period with less scar tissue formation [2,3,5]. However, there are some disadvantages of one-stage lengthening, such as a small gain in length, morbidity of the donor site, neurovascular impairment caused by rapid stretching, graft problems related to multiple lengthening and the limitation of range of motion due to cast immobilisation [2,3].…”

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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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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“…Authors [2] performed one-stage lengthening using intercalary autogenous bone graft. Choi et al [2], showed the advantages of onestage lengthening with intercalary bone graft over gradual lengthening by callotasis including shorter period of consolidation, lesser scar and better psychological acceptation.…”

Section: Discussionmentioning

confidence: 99%

“…One-stage lengthening with an interpositional bone graft or gradual lengthening by callotasis are the two most widely used techniques [2,3]. For brachymetatarsia, numerous variables must be assessed, including the number of rays affected, the associated deformities, the soft-tissue contracture, and the tension of the skin.…”

Section: Introductionmentioning

confidence: 99%

New Concept for Correction of Brachymetatarsy by 3D CT-Scan Measurement

Bonnel¹

2014

J Biosens Bioelectron

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We reported progressive metatarsal lenghtening by external fixator after osteotomy by open approach without bone interposition in a case of brachymetatarsia upon the third and fourth metatarsals. After a tomodensitometry planification, the biometry of the five metatarsal bones was done by X-ray and CT scan by measuring each metatarsal length (1 to 5) in the sagittal, horizontal and coronal plans and angles. The average amount of lengthening was 17 mm for the third and 15 mm the fourth at the end, 40% of the original length (range, 36 to 44%). In the same time, we treated hallux valgus by osteotomy. Decrease of motion and joint deformity did not occur. The control of the CT scan allowed choosing the real orientation and length of the two metatarsal bones to obtain an adequate parabola. Measurements with CT scan were more reliable than Xray.

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Metatarsal Lengthening in Congenital Brachymetatarsia: One-Stage Lengthening Versus Lengthening by Callotasis

Cited by 45 publications

References 9 publications

One-stage Metatarsal Lengthening by Allograft Interposition: A Novel Approach for Congenital Brachymetatarsia

One-stage Metatarsal Lengthening by Allograft Interposition: A Novel Approach for Congenital Brachymetatarsia

Lengthening of short bones by distraction osteogenesis—results and complications

New Concept for Correction of Brachymetatarsy by 3D CT-Scan Measurement

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