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DOI: 10.1055/s-0041-1735828
Treatment of Brachymetatarsia by Distraction Osteogenesis Using Monolateral External Fixator
Article in several languages: português | English
Abstract
Objective To describe the profile of the patients and the results obtained with the use of an external fixator for metatarsal lengthening in brachymetatarsia.
Methods A retrospective analysis of the medical records of patients with brachymetatarsia treated between January 2018 and April 2020 was performed. During this period, eight feet of six patients were operated on. Frequencies were estimated according to demographic and surgical aspects.
Results All patients (100%; n = 6) were female, with a mean age of 28 years old, ranging from 15 to 48 years old, and were motivated to seek the orthopedic service due to aesthetic deformity. The deformity was bilateral in two patients and unilateral in four patients. The average lengthening time was 22 days ( ± 7.15, 95% confidence interval [CI]: 19.04–26.81). The lengthening speed was 0.5 mm/day, and the average total length of the lengthening was 11.46 mm ( ± 3.57; 95%CI: 9.52–13.40). Half of the patients (50%; n = 3) had local infection of the pins and were treated with antibiotics, and the others did not report any postsurgical complications. All patients denied pain or calluses after the surgical procedure and reported satisfaction with the results.
Conclusion All patients were female and sought surgery for brachymetatarsia for aesthetic reasons. Osteogenic distraction at a rate of 0.5 mm/day resulted in successful lengthening of the metatarsal, with a low frequency of complications, good clinical outcomes, and high patient satisfaction.
Financial Support
There was no financial support from public, commercial, or non-profit sources.
The present work was developed at the Hospital de Urgências de Goiânia - State Department of Health, Goiânia, GO, Brazil.
Publication History
Received: 07 January 2021
Accepted: 02 June 2021
Article published online:
01 October 2021
© 2021. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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Referências
- 1 Rocha FA, Mansur H, Meira RB, Gusmão L, Gonçalves CB, Castro Júnior IM. One-stage correction of multiple brachymetatarsia and hallux valgus with calcaneal autograft. Sci J Foot Ankle 2018; 12 (04) 342-346
- 2 Kim HT, Lee SH, Yoo CI, Kang JH, Suh JT. The management of brachymetatarsia. J Bone Joint Surg Br 2003; 85 (05) 683-690
- 3 Smolle E, Scheipl S, Leithner A, Radl R. Management of congenital fourth brachymetatarsia by additive autologous lengthening osteotomy (AALO): a case series. Foot Ankle Int 2015; 36 (03) 325-329
- 4 Desai A, Lidder S, Armitage AR, Rajaratnam SS, Skyrme ADS. Brachymetatarsia of the fourth metatarsal, lenghtening scarf osteotomy with bone graft. Ortop Rev (Pavia) 2013; 5 (03) e21
- 5 Lara LCR, Franco Filho N, Marques AFS. Tratamento cirúrgico da braquimetatarsia. Rev ABTPe 2008; 2 (01) 7-11
- 6 Lee WC, Suh JS, Moon JS, Kim JY. Treatment of brachymetatarsia of the first and fourth ray in adults. Foot Ankle Int 2009; 30 (10) 981-985
- 7 Scher DM, Blyakher A, Krantzow M. A modified surgical technique for lengthening of a metatarsal using an external fixator. HSS J 2010; 6 (02) 235-239
- 8 Giannini S, Faldini C, Pagkrati S, Miscione MT, Luciani D. One-stage metatarsal lengthening by allograft interposition: a novel approach for congenital brachymetatarsia. Clin Orthop Relat Res 2010; 468 (07) 1933-1942
- 9 Lee KB, Yang HK, Chung JY, Moon ES, Jung ST. How to avoid complications of distraction osteogenesis for first brachymetatarsia. Acta Orthop 2009; 80 (02) 220-225
- 10 Iida N, Watanabe A. A new surgical procedure for brachymetatarsia by a hydroxyapatite graft. Eur J Plast Surg 2013; 36: 41-44
- 11 Lamm BM. Percutaneous distraction osteogenesis for treatment of brachymetatarsia. J Foot Ankle Surg 2010; 49 (02) 197-204
- 12 Shim JS, Park SJ. Treatment of brachymetatarsia by distraction osteogenesis. J Pediatr Orthop 2006; 26 (02) 250-254
- 13 Barik S, Farr S. Brachymetacarpia and brachymetatarsia: do we need to operate?. EFORT Open Rev 2021; 6 (01) 15-23
- 14 Shecaira AP, Fernandes RMP. Brachymetatarsia: One-stage Versus Two-Stage Procedures. Foot Ankle Clin 2019; 24 (04) 677-687
- 15 Lee KB, Park HW, Chung JY, Moon ES, Jung ST, Seon JK. Comparison of the outcomes of distraction osteogenesis for first and fourth brachymetatarsia. J Bone Joint Surg Am 2010; 92 (16) 2709-2718
- 16 Peña-Martínez VM, Palacios-Barajas D, Blanco-Rivera JC. et al. Results of External Fixation and Metatarsophalangeal Joint Fixation With K-Wire in Brachymetatarsia. Foot Ankle Int 2018; 39 (08) 942-948
- 17 Lamm BM, Gourdine-Shaw MC. Problems, obstacles, and complications of metatarsal lengthening for the treatment of brachymetatarsia. Clin Podiatr Med Surg 2010; 27 (04) 561-582
- 18 Hurst JM, Nunley II JA. Distraction osteogenesis for the shortened metatarsal after hallux valgus surgery. Foot Ankle Int 2007; 28 (02) 194-198
- 19 Masada K, Fujita S, Fuji T, Ohno H. Complications following metatarsal lengthening by callus distraction for brachymetatarsia. J Pediatr Orthop 1999; 19 (03) 394-397
- 20 Lee WC, Yoo JH, Moon JS. Lengthening of fourth brachymetatarsia by three different surgical techniques. J Bone Joint Surg Br 2009; 91 (11) 1472-1477
- 21 Fusini F, Langella F, Catani O, Sergio F, Zanchini F. Mini-invasive treatment for brachymetatarsia of the fourth ray in females: percutaneous osteotomy with mini-burr and external fixation-a case series. J Foot Ankle Surg 2017; 56 (02) 390-394