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First experience with a distraction apparatus prototype (SM-fix-phalanx distractor) for phalanges lengthening
1Department of Pediatric Surgery, University Children's Hospital, Basel, Switzerland.
Insights
This study shows a new external fixator and distractor system effectively lengthens phalanges in children with traumatic amputations, improving function and appearance. Bone grafting is unnecessary due to children
Area of Science:
- Pediatric Orthopedics
- Traumatology
- Hand Surgery
Background:
- Traumatic partial phalangeal amputations in children present reconstructive challenges.
- Previous methods may require bone grafting and extensive surgical intervention.
- Developing minimally invasive techniques for pediatric hand reconstruction is crucial.
Observation:
- Seven children (aged 5-17) with 10 partially amputated phalanges were treated.
- A novel external fixator and distractor system was employed for phalanx lengthening.
- Distraction osteogenesis achieved phalanx lengthening of 3-10 mm (average 55% of remaining phalanx).
Findings:
- Significant functional and cosmetic improvements were observed, particularly in distal phalanx amputations with resulting nail dystrophy (claw nail).
- Average distraction and consolidation phases lasted 5 weeks, with aftercare ranging from 2-12 months.
- Children's robust distraction-histogenesis capability eliminated the need for bone grafting, provided the integument was intact or prepared.
Implications:
- The external fixator and distractor system is well-suited for delicate pediatric hand anatomy.
- This method offers a less invasive approach, potentially reducing complications and recovery time.
- Further research could explore long-term outcomes and broader applications in pediatric hand trauma.
Abstract:
Since 1991 seven children aged between 5-17 years have been treated at the University Children's Hospital in Basel for 10 traumatically partially amputated phalanges with a newly developed external fixator and distractor. Through continual distraction of the osteotomy a phalanx lengthening of 3-10 mm has been achieved (on average 55% of the rest phalanx). The results of this method in distal phalanx amputation with resulting nail dystrophy (claw nail) has shown functional and cosmetic improvements. The average distraction and consolidation phases lasted 5 weeks. The after care lasted 2-12 months. As children have good distraction-histogenesis bone grafting is not necessary. A prerequisite would be, however, an intact or appropriately prepared integument. The advantage of this external fixator and distractor system is that it is suitable for the delicate anatomical structures of a child's hand. The distractor component is only necessary for a distraction step to be carried out. A further advantage of this system is the relatively light but stable construction.