Fourth Brachymetatarsia Treated by Distraction Osteogenesis / 대한정형외과학회잡지

ABSTRACT

PURPOSE: We retrospectively reviewed outcomes, complications and their influencing factors after distraction osteogenesis for fourth brachymetatarsia. MATERIALS AND METHODS: We performed twenty-two cases of metatarsal lengthening with external fixator in sixteen patients for fourth brachymetatarsia from May 1998 to May 2000. At the final follow-up, AOFAS scores were awarded according to stiffness, pain, function, alignment and the satisfaction of patients. RESULTS: On average, the gain in length was 16.5 mm, the percentage of lengthening 38.9%, and the healing index 72.9 days/cm. There were some complications including subluxation of the metatarsophalangeal joint in 7 cases, stiffness in 5 cases, pin tract infection in 2 cases, and angular deformity in 3 cases. Those having a percentage of lengthening of less than 40% and those involving only the metatarsus had better results. Most patients were satisfied with the corrected result, though one unsatisfied patient underwent revision surgery. CONCLUSION: Even though distraction osteogenesis for fourth brachymetatarsia is effective, excessive lengthening in patients involving both metatarsus and phalange can produce minor complications.