[Distraction Osteogenesis is an Effective Method to Lengthen Digits in Congenital Malformations]

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Pediatric Orthopedics

Background:

• Congenital hand deficiencies present significant reconstructive challenges.
• Distraction osteogenesis offers a method for bone lengthening in pediatric patients.

Purpose of the Study:

• To determine the feasible amount of bone lengthening using distraction osteogenesis in congenital hand deficiencies.
• To evaluate the efficacy and outcomes of metacarpal and phalangeal lengthening.

Main Methods:

• Retrospective review of 60 patients (1.6-17.8 years) undergoing lengthening of 71 bones (46 metacarpals, 25 phalanges).
• Analysis of preoperative and post-fixator removal radiographs to measure lengthening.
• Review of patient charts for surgical details, consolidation times, and complications.

Main Results:

• Average metacarpal lengthening was 18.4 mm (73%); average phalangeal lengthening was 14.0 mm (77%).
• Lengthening exceeding 100% of the original bone length was achievable for both metacarpals and phalanges.
• A 30% complication rate was observed, including early consolidation and joint issues, all treatable with acceptable results.

Conclusions:

• Distraction osteogenesis is an effective, though demanding, technique for ray reconstruction in congenital hand malformations.
• Significant bone lengthening, over 100%, is possible.
• Complications are frequent but generally manageable, yielding satisfactory results.