Distraction Lengthening of Thumb Metacarpal

Abstract

The purpose of this retrospective study was to evaluate the clinical outcome of distraction lengthening of the thumb metacarpal without bone grafting in seven patients with traumatic thumb loss. The distraction was stopped after 57 (range, 42 to 91) days, giving a median lengthening of 28 (range, 20-36)mm. It took an average of 155 (range, 118-196) days for bony consolidation to occur. The mean pinch power was 72% of that of the uninjured hand. The two-point discrimination on the pulp of the reconstructed thumb was 10 (range, 8-12)mm. There were no major complications.

La distraction osseuse progressive au niveau métacarpien ou phalangien chez l'enfant

“…Concernant notre cas de fracture, qui est survenue sur un os consolidé, cela nous a amenés à proposer au moindre doute une mise en place de broche axiale lors de l'ablation du fixateur externe pour éviter toute fracture sur un os certes consolidé mais encore fragile vis-à-vis des traumatismes [13].…”

Daumenverlängerung nach traumatischer Amputation auf Grundphalanxhöhe mit semizirkulärem Distraktions-Fixateur: Ergebnisse von 5 Fällen

“…Die gesunde Gegenseite dient als Referenz, um den Endpunkt der Distraktion zu bestimmen [9]. In der Literatur werden Verlängerungen zwischen 20-28 mm beschrieben, sodass wir mit unseren Werten von 23-30 mm eher im oberen Verlängerungsbereich liegen [10,11].…”

Amputations, replantation and thumb reconstruction

“…The thumb is reconstructed either by this alone or with an interim iliac crest bone graft to increase the length of the construct. 78,79 The length of bone distracted can be up to 3 cm while still maintaining adequate soft tissue cover and sensation. Further modifications of this method using preoperative distraction lengthening, extended length and combined with a second toe proximal interphalangeal joint have all been described.…”

“…The transferred toe is narrower and more 'thumb like' than the traditional great toe transfer, but still has the aesthetic and functional elements to provide a valuable and useful thumb reconstruction. 79 This technique can also be used in conjunction with vascular toe transfers to improve the donor defect of the foot. [73][74][75] Distraction lengthening Continual distraction lengthening of the thumb was first described by Matev in 1973.…”