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Callus distraction for brachymetatarsia - A comparison between an internal device and the external fixator
Gregor Toporowski1, Roman Thiesen1, Georg Gosheger2
1General Orthopaedics and Tumour Orthopaedics, Muenster University Hospital, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany; Children's Orthopaedics, Deformity Correction and Foot Surgery, Muenster University Hospital, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany.
Background:
Symptomatic patients with severe brachymetatarsia are commonly treated with callus distraction using external mini-fixator (EF) or internal device (ID). This study points out advantages and limitations of both methods comparing clinical and radiographical parameters.
Methods:
Retrospective analysis of 21 metatarsal bones in twelve patients. Twelve metatarsals were treated with ID (Genos Mini), nine with EF (MiniRail).
Results:
Mean lengthening distance was 17.3 mm using EF and 11.7 mm using ID (p = 0.016). Adverse results were observed in 89% of metatarsals treated with EF and in 33% treated with ID (p = 0.011). Postoperative surgical intervention was required in 33% using EF compared to 0% using ID (p = 0.031). Mean total German Foot Function Index (FFI-T) improved from 49 to 33 using EF and from 47 to 22 using ID (p < 0.001).
Conclusion:
CD is a reliable surgical treatment for BMT. Surgeons should be aware of implant-related advantages and complications when counseling patients about treatment options.
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