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Metacarpal Lengthening Using a Mini-Ring Ilizarov Device for Thumb Reconstruction.

Yueliang Zhu¹, Yongqing Xu², Shaoquan Pu²

¹Department of Orthopedic Surgery. 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China.

The Journal of Hand Surgery

|March 16, 2023

Summary

The mini-ring Ilizarov external fixator effectively lengthens the thumb metacarpal bone. This device is compatible with simultaneous groin flap procedures for thumb reconstruction.

Keywords:

Ilizarov technique metacarpal lengthening thumb defect

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Area of Science:

Orthopedic surgery
Reconstructive surgery
Traumatology

Background:

Thumb metacarpal defects pose significant functional challenges.
Metacarpal lengthening is crucial for restoring thumb function.
Simultaneous soft tissue coverage is often required for complex thumb injuries.

Purpose of the Study:

To evaluate the efficacy of the mini-ring Ilizarov external fixator for thumb metacarpal lengthening.
To assess the compatibility of this device with concurrent groin flap procedures.
To determine the outcomes of this combined approach in thumb reconstruction.

Main Methods:

A cohort of 17 adult patients with thumb loss underwent metacarpal lengthening using a mini-ring Ilizarov device.
The fixator comprised two rings, threaded rods, nuts, and K-wires.
Six patients received a simultaneous groin flap transfer, with pedicle division after one month.
Lengthening commenced three days post-surgery at 0.66 mm/day.

Main Results:

Patients were followed for an average of 21.9 months.
The average lengthening period was 29.1 days, achieving an additional 1.9 cm of length.
The healing index was used to evaluate lengthening efficiency.

Conclusions:

The mini-ring Ilizarov fixator is a straightforward device for primary metacarpal lengthening.
This technique is suitable for single-stage thumb lengthening and reconstruction, even with bone exposure.
The device demonstrates compatibility with simultaneous groin flap procedures.