Distraction lengthening by callotasis of traumatically shortened bones of the hand

Hosny, Gamal Ahmed; Kandel, Wael A

doi:10.1097/ta.0b013e31824b177a

Cited by 13 publications

(12 citation statements)

References 11 publications

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“…There are a few papers in the English literature reporting a small number of cases of short bone lengthening. Distraction histeogenesis (callotasis) was applied in a single stage and gradual lengthening for congenital and traumatic phalangeal shortening or amputation was achieved with excellent outcomes [66]. Two-stage treatment was also used including osteotomy and gradual distraction followed by bone graft [67].…”

Section: Upper Extremity Lengtheningmentioning

confidence: 99%

Limb lengthening history, evolution, complications and current concepts

Hosny

2020

J Orthop Traumatol

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Limb lengthening continues to be a real challenge to both the patient and the orthopaedic surgeon. Although it is not a difficult operative problem, there is a long and exhausting postoperative commitment which can jeopardize early good results. I aim to review the history, evolution, biology, complications and current concepts of limb lengthening. Ilizarov's innovative procedure using distraction histeogenesis is the mainstay of all newly developing methods of treatment. The method of fixation is evolving rapidly from unilateral external fixator to ring fixator, computer assisted and finally lengthening intramedullary nails. The newly manufactured nails avoid many of the drawbacks of external fixation but they have their own complications. In general, the indications for limb lengthening are controversial. The indications have been extended from lower limb length inequality to upper extremity lengthening, including humeral, forearm and phalangeal lengthening. A wide range in frequency of complications is recorded in the English literature, which may reach up to 100% of cases treated. With developing experience, cosmetic lengthening has become possible using external or internal lengthening devices with an acceptable rate of problems. Level of evidence: V.

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Section: Upper Extremity Lengtheningmentioning

confidence: 99%

Limb lengthening history, evolution, complications and current concepts

Hosny

2020

J Orthop Traumatol

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“…5,10-12 Callotasis of the proximal phalanx of the thumb or the first metacarpal bone in posttraumatic stumps is an effective reconstruction method to compensate for the loss of functions and deformity correction. 12,13 A short summary of the technical solutions that are based on the author's practical experience has been presented above. They were used in posttraumatic cases for lengthening of 104 proximal phalanges, 9 middle phalanges, and 2 distal phalanges.…”

Section: Discussionmentioning

confidence: 99%

Phalangeal Lengthening Techniques for Brachydactily and Posttraumatic Digital Stumps With the Use of a Modified External Mini-Fixator

Danilkin

2016

Techniques in Hand &Amp; Upper Extremity Surgery

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Distraction osteogenesis has become the most used method for bone lengthening and deformity correction including the bones of the hand and foot. The principle techniques used for hand bone lengthening in posttraumatic and congenital conditions using available external fixators are based on this method. We present the technical specifications and surgical techniques with the use of a mini-fixator that was specially designed for short tubular bones. The surgical techniques of lengthening and web space skin stock creation for future web-pasty are supplied with the diagrams of their application to phalanges and illustrative clinical cases. Between 1999 and 2012, this mini-fixator was used for lengthening of 223 finger segments at our hospital and provided improvement of the hand esthetics and functions.

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“…Studies show that minor complications (e.g., pin site infections) are common during distraction, occurring in patients who undergo callotasis or the two-stage appro ach. 11,19,32,[34][35][36] Although major complications are more common in the two-stage approach compared to callotasis, they are typically rare. 19,32,34,37,38 In our cohort, major complications, such as malunion and delayed union, occurred in one patient each.…”

Section: Ementioning

confidence: 99%

“…11,19,32,[34][35][36] Although major complications are more common in the two-stage approach compared to callotasis, they are typically rare. 19,32,34,37,38 In our cohort, major complications, such as malunion and delayed union, occurred in one patient each. Lastly, approximately 13 percent of patients experienced at least one nail-related complication.…”

Section: Ementioning

confidence: 99%

Distraction Lengthening of the Apert Thumb

Upton¹,

McNamara²,

Ali³

et al. 2022

Plastic &Amp; Reconstructive Surgery

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Background: The thumbs of patients with Apert syndrome are characteristically short and radially deviated, contributing to functional hand impairment. The authors report a two-staged technique for distraction lengthening of the Apert thumb using a robust cohort of pediatric patients. Methods: The authors retrospectively reviewed medical records of pediatric patients with Apert syndrome who underwent thumb distraction lengthening between 1999 and 2019. The technique was two-staged: (1) application of uniplanar distractor and phalangeal osteotomy, followed by (2) distractor removal, bone grafting, and fixation. Clinical records, preoperative and postoperative radiographs, and photographs were reviewed. Results: Twenty-two patients (41 thumbs) with Apert syndrome were identified and treated (mean age at initial distraction, 11.5 years). A mean distraction gap of 31.3 mm was achieved over a median time of 40.0 days. The mean healing index was 26.3 days per centimeter. The thumbnail complex was lengthened a median length of 3.0 mm. The median follow-up time was 5.0 years, with complications occurring in 36.4 percent (eight out of 22) of patients. A delayed bone union occurred in one patient, and rotational malunion occurred in one patient. Conclusion: Although long-term outcomes data are needed, thumb distraction lengthening following syndactyly release in patients with Apert syndrome is safe and should be considered to augment the overall appearance and functionality of the hand. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

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Distraction lengthening by callotasis of traumatically shortened bones of the hand

Abstract: Therapeutic study, level V.

Cited by 13 publications

References 11 publications

Limb lengthening history, evolution, complications and current concepts

Limb lengthening history, evolution, complications and current concepts

Phalangeal Lengthening Techniques for Brachydactily and Posttraumatic Digital Stumps With the Use of a Modified External Mini-Fixator

Distraction Lengthening of the Apert Thumb

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