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Percutaneous distraction lengthening in brachymetacarpia
Alexander D Volpi1, Austin T Fragomen
1Wake Forest University, Winston-Salem, North Carolina, USA. alex.volpi20@gmail.com
Orthopedics
|August 6, 2011
Summary
Brachymetacarpia, a condition causing shortened metacarpals, can be effectively treated with gradual distraction lengthening. This minimally invasive technique achieved excellent cosmetic results in a case study.
Area of Science:
- Orthopedic surgery
- Hand surgery
- Pediatric orthopedics
Background:
- Brachymetacarpia, characterized by shortened metacarpals due to premature epiphyseal plate closure, is typically addressed for cosmetic enhancement.
- While various surgical lengthening techniques exist, gradual distraction lengthening is favored for its superior cosmetic outcomes and minimal complications.
Observation:
- A 16-year-old female presented with a 12 mm deficit in her left ring finger length compared to the contralateral side.
- The patient exhibited normal joint mobility, with brachymetacarpia being the primary concern.
Findings:
- A minimally invasive, percutaneous distraction lengthening procedure was performed using an external fixator.
- The 12 mm length deficit was corrected within 6 weeks, with a total fixation period of 14 weeks.
- The healing index was 81 days/cm, and the only complication was two minor pin site infections treated with antibiotics.
Implications:
- Gradual distraction lengthening via a percutaneous approach offers a safe and effective method for correcting brachymetacarpia.
- This technique yields excellent cosmetic results with a low complication rate, making it a viable option for patients seeking functional and aesthetic improvement.
