Related Experiment Video
Updated: Jun 26, 2026
Three-Dimensional Preoperative Virtual Planning in Derotational Proximal Femoral Osteotomy
Published on: February 17, 2023
Modified step-cut osteotomy for metacarpal and phalangeal rotational deformity
Andrew Jawa1, Maura Zucchini, Guilio Lauri
1Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA 02114, USA. ajawa@partners.org
Purpose:
Rotational deformity of metacarpal and phalangeal fractures can jeopardize normal hand function and cause aesthetic problems for patients. We have found the Z-cut metacarpal osteotomy, initially described by Manktelow, to prove predictable and provide precise restoration of rotation and function. Therefore, we reviewed our experience with this technique.
Methods:
The senior authors identified 12 patients treated with rotational step-cut osteotomies for digital rotatory deformities. The cases were reviewed retrospectively. Seven had metacarpal and five had phalangeal malunions.
Results:
All 12 patients had correction of their deformities, obtained union of the osteotomy, and maintained or improved their motion. There were no perioperative complications.
Conclusions:
Metacarpal step-cut osteotomies are a technically simple and effective method for correction of digital rotational deformities resulting from fracture malunions. Unlike other types of osteotomies, this technique affords precise intraoperative control at the osteotomy site, a large surface area for bony healing, and rigid fixation with early digital motion.
