Metacarpal Distraction Lengthening

Smith, Richard J.; Gumley, Graham J.

doi:10.1016/s0749-0712(21)01372-x

Cited by 49 publications

(3 citation statements)

References 12 publications

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“…Matev (1980) recommended that patients aged 20 years and older with gaps of 3 cm or more receive bone graft. Kessler et al (1979) and Smith and Gumley (1985) noted that spontaneous union and consolidation of the zone of distraction was unpredictable and took too long. They thus recommended the use of bone graft in all instances, not only to decrease the period of immobilization and speed functional recovery, but also to diminish the incidence of complications associated with the prolonged external fixation.…”

Section: Discussionmentioning

confidence: 99%

“…Distraction osteosynthesis (callotasis) is an established option for thumb reconstruction but remains controversial (Matev, 1989). Some surgeons prefer gradual lengthening followed by bone grafting (Cobb et al, 1990; Hette et al, 1992),while others do not recommend the procedure because of the long periods of treatment and risk of complications, such as fracture or pseudarthrosis (Smith and Gumley, 1985).…”

Section: Introductionmentioning

confidence: 99%

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Distraction Lengthening of Thumb Metacarpal

Heitmann

Levin

2004

Journal of Hand Surgery

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Distraction Lengthening of Thumb Metacarpal

Heitmann

Levin

2004

Journal of Hand Surgery

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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%

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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Toe transfer for congenital hand defects

Eaton

Lister

1991

Microsurgery

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Toe-to-hand transfer is a well-established reconstructive option for certain congenital hand anomalies. It is the only technique which can add growth potential to the immature skeleton. Toe transfer is best suited for constriction ring amputations, which have relatively normal proximal anatomy. Transfers should be performed early in life to avoid lack of cortical integration of the new part. Anatomic variations of both hand and foot are often encountered, which influence both operative approach and functional prognosis. Indications, techniques, and complications are reviewed.

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Metacarpal Distraction Lengthening

Cited by 49 publications

References 12 publications

Distraction Lengthening of Thumb Metacarpal

Distraction Lengthening of Thumb Metacarpal

Distraction Lengthening of the Apert Thumb

Toe transfer for congenital hand defects

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