"Callus Bending Technique" Following Gradual Bone Lengthening for Functional Reconstruction in Cases of Phalangeal
1Hand and Microsurgery Center, Osaka Ekisaikai Hospital of Japan Seafarers and Relief Association, Osaka, Japan.
Purpose:
The purpose of this study was to introduce the "Callus bending technique" following gradual bone lengthening for functional reconstruction. We report cases of segmental phalangeal loss with replanted incomplete amputation and distal finger amputation.
Methods:
Herein, we report two cases to introduce the "callus bending technique": one in which the "callus bending technique" was adopted after gradual bone lengthening for amputated digital stumps, and the other, a case of incomplete digital amputation, in which defects in the replanted middle phalanges were filled by distraction lengthening of the proximal phalanx, followed by use of the callus bending technique.
Results:
The patients could almost touch their palms with the tips of their injured fingers when they flexed their metacarpophalangeal joint of the digit fully. When he extended the metacarpophalangeal joint of the injured fingers fully, the hand looked almost natural, and he could push a table. For the patient with incomplete digital amputation, the distal interphalangeal joint was also reconstructed using the joint surfaces of the distal and proximal phalanges.
Conclusions:
Both patients were satisfied with both the functional and cosmetic improvement of their fingers and returned to their work as carpenters. In both cases, an external fixator, the Ilizarov minifixator, was used, as it affords relatively great flexibility.
Clinical Relevance:
Adoption of this technique involves the use of multiple surgical procedures, but it eventually yields reasonable cosmetic and functional results. We propose the use of this technique as the technique of choice for amputated fingers or severe bone loss due to trauma.
