Factors That Affect the Healing Index of Metacarpal Lengthening: A Retrospective Study (original) (raw)

Lengthening by distraction osteogenesis in congenital shortening of metacarpals

2013

The aim of this study was to present the results of seven cases of metacarpal lengthening by distraction osteogenesis and to discuss the ideal daily rate of distraction. Methods: Metacarpal lengthening was performed by distraction osteogenesis in the seven metacarpals of four patients (3 females, 1 male; mean age: 14.9 years). A unilateral external fixator was used for lengthening. Lengthening was initiated with a distraction rate of 2×0.5 mm/day in the patient with bilateral involvement of the middle and ring metacarpals. On the tenth day of lengthening, distraction was discontinued due to pain and contracture. Then, distraction was continued with a rate of 2×0.25 mm/day. In all other cases, the distraction rate was 0.5 mm/day. Pre-and postoperative range of motion was measured with a goniometer. Patient satisfaction was evaluated with visual analog scale. Results: The mean pre-and postoperative metacarpal lengths were 34.6 mm (range: 33 to 37) and 49.7 mm (range: 47 to 52), respectively. The mean lengthening achieved was 15.1 mm (range: 14 to 17), while the mean distraction rate was 0.55 mm/day (range: 0.48 to 0.63). No functional loss was observed in the fingers at the final check-up. The patients were happy with the functional and cosmetic results. Conclusion: Distraction osteogenesis is a safe method providing acceptable cosmetic and functional results in patients with congenital metacarpal shortness. The length of metacarpals and muscles that will be affected from lengthening should be considered when determining the daily rate of distraction.

Metacarpal and Phalangeal Lengthening of the Hand

The Professional Medical Journal, 2012

Objectives: To present our experience of distraction osteogenesis in Metacarpal and Phalangeal lengthening of the hand andanalyze the factors which influence the period of healing. Design: Experimental study. Period: December 2008 to April 2011. Setting:Department of Plastic and Reconstructive Surgery, Khyber Teaching Hospital, Peshawar. The patients were admitted through out-patientdepartment and detailed history, clinical examination and necessary investigations were carried out. Informed consent was taken. Distractionhas been performed in six metacarpal bones and four phalangeal bones in nine patients. The age ranged from 3 to 59 years. All the digits hadtraumatic amputations. The injury was in the right hand (dominant) in 6 patients and in the left hand in 3 patients. An isolated injury to the thumbwas seen in 4 patients, while in the remaining patients other fingers had been injured. All patients were operated by the same surgeon usingsimilar lengthening technique. Patients wer...