Subacute two stage metatarsal lengthening with gradual distraction for brachymetatarsia: A consecutive case series and literature review |
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| Affiliation: | 1. Department of Orthopaedics, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan;2. Department of Physical Therapy, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan;1. Orthopedic Surgery Department, Hospital de Braga, Braga, Portugal;2. Orthopedic Surgery Department, Hospital Vila Franca de Xira, Vila Franca de Xira, Portugal;3. Clínica Espregueira – FIFA Medical Centre of Excellence, Porto, Portugal;4. Hospital Santa Maria Maior, EPE, Barcelos, Portugal;5. Hospital Lusíadas Braga, Braga, Portugal;6. Dom Henrique Research Centre, Porto, Portugal;7. School of Medicine, University of Minho, Braga, Portugal;8. Human anatomy Unit, School of Medicine, University of Barcelona, Foot and Ankle Unit, Barcelona, Spain;9. INSIDE, Investigation in Orthopedics, Braga, Portugal;10. ICVS/3B’s–PT Government Associate Laboratoryō, Braga, Guimarães, Portugal;11. Porto Biomechanics Laboratory (LABIOMEP), Faculty of Sports, University of Porto, Porto, Portugal;12. 3B’s Research Group – Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Barco, Guimarães, Portugal;13. Clinica del Remei, Barcelona, Spain;1. Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran;2. Students'' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran;3. Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran;4. Rothman Orthopaedics Florida at AdventHealth, Orlando, FL, USA;5. Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran;1. University Hospital Virgen del Rocío, Seville, Spain;2. George Eliot Hospital, Nuneaton, UK;3. Head of Foot Ankle Unit University Hospital Virgen del Rocío, Seville, Spain;1. The University of Kansas Medical Center, Kansas City, KS, United States;2. The University of Kansas School of Medicine, Wichita, KS, United States;1. Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen 518000, Guangdong Province, China;2. Shenzhen Second People’s Hospital, Shenzhen 518000, Guangdong Province, China;1. Orthopedics and Traumatology Unit, Centro Hospitalar Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal;2. Hospital II Vitarte Essalud, Lima, Peru;3. Molecular Oncology and Embryology Laboratory, Human Anatomy Unit, Department of Surgery and Surgical Specializations, Faculty of Medicine and Health Sciences, University of Barcelona, IDIBAPS, Barcelona, Spain;4. Human Anatomy Unit, Department of Surgery and Surgical Specializations, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain;5. Clinica Nostra Senyora del Remei, Barcelona, Spain |
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| Abstract: | BackgroundThis study examined the functional and clinical outcomes of subacute two stage metatarsal lengthening with gradual distraction for brachymetatarsia. This technique was developed to overcome the disadvantages of one-stage metatarsal lengthening and gradual distraction.MethodsFour feet of three patients with congenital brachymetatarsia underwent subacute two stage metatarsal lengthening with gradual distraction. Pain, function, and alignment were assessed preoperatively and at follow-ups using the American Orthopaedic Foot and Ankle Society (AOFAS) lesser metatarsophalangeal–interphalangeal scale, and any complications were recorded.ResultsThe patients were followed up for a mean of 18.1 ± 6.9 (range, 12.6–28.1) months. The mean metatarsal length gain was 15.2 ± 3.2 (range, 12.1–18.5) mm, and the corresponding percent increase was 32.5 % ± 7.0 % (range, 25.7–41.1 %). The mean AOFAS score (0?100) was 97.5 ± 5.0 at the final follow-up. The external fixator index was 10.2 ± 1.5 (range, 8.1–11.6) days/cm. None of the patients experienced metatarsophalangeal stiffness, subluxation or dislocation of the metatarsophalangeal joint, loss of correction, pin tract infection, delayed union, nonunion, or angular deformities.ConclusionSubacute two stage metatarsal lengthening with gradual distraction is a reliable alternative treatment for brachymetatarsia. |
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| Keywords: | Brachymetatarsia Metatarsal lengthening One-stage metatarsal lengthening Gradual distraction |
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