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Mahmut Kömürcü1, Mustafa Kürklü, Bahtiyar Demiralp

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Summary

Metacarpal lengthening using callus distraction offers a functional and cosmetic solution for traumatic thumb amputations. This technique improves outcomes compared to traditional prostheses for thumb amputations.

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Area of Science:

  • Orthopedic Surgery
  • Reconstructive Surgery

Background:

  • Thumb amputation at the metacarpophalangeal joint presents aesthetic and functional challenges.
  • Standard prostheses for this amputation level are often bulky and unacceptable.

Purpose of the Study:

  • To evaluate the efficacy of metacarpus lengthening by callus distraction for traumatic thumb amputations.
  • To assess functional and cosmetic outcomes of this reconstructive technique.

Main Methods:

  • Twelve male patients with traumatic thumb amputations underwent metacarpal lengthening via callus distraction.
  • External fixators (mini Ilizarov or uniplanar dynamic) were used for distraction.
  • Webplasty was performed in all cases, with functional outcomes assessed using DASH scores and pick-up tests.

Main Results:

  • Successful union of the lengthened segment was achieved in all cases, with an average lengthening of 28.9 mm.
  • Average healing time was 2.1 months, with a healing index of 0.73 month/cm.
  • Pin tract infection occurred in 58.3% of cases; one case of volar angulation was noted post-fixator removal.

Conclusions:

  • Metacarpus lengthening by callus distraction is a functionally and cosmetically effective method for reconstructing traumatic thumb amputations.
  • The technique facilitates the fabrication of acceptable thumb prostheses through distraction and webplasty procedures.