A Modified Surgical Technique for Lengthening of a Metatarsal Using an External Fixator
First Online: 19 March 2010 Received: 26 August 2008 Accepted: 08 February 2010 DOI:
10.1007/s11420-010-9160-5 Cite this article as: Scher, D.M., Blyakher, A. & Krantzow, M. HSS Jrnl (2010) 6: 235. doi:10.1007/s11420-010-9160-5 Abstract
Brachymetatarsia is a congenital or developmental condition that results in a short metatarsal. Problems that arise from this condition can include pain, difficulty with shoe wear, and cosmetic concerns. Multiple techniques have been described that successfully correct the deformity, including both acute and gradual distraction. We describe a modification of the technique of gradual lengthening by way of distraction osteogenesis in which an axial transarticular K-wire is incorporated into a monolateral frame, thereby increasing the stability of the construct and potentially minimizing complications.
Keywords metatarsal lengthening brachymetatarsia external fixator distraction osteogenesis
Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution has approved the reporting of this case and that all investigations were conducted in conformity with ethical principles of research.
Mah KK, Beegle TR, Falknor DW. A correction for short fourth metatarsal. J Am Podiatr Med Assoc. 1983;73:196Y200.
Urano Y, Kobayashi A. Bone lengthening for shortness of the fourth toe. J Bone Joint Surg Am. 1978;60:91Y93.
Bioke AM, Gerber MR, Snyder AJ. Brachymetatarsia. Axial lengthening by using the callus distraction technique. J Am Podiatr Med Assoc 1993; 7:373–378.
Ferra´ndez L, Yubero J, Usabiaga J, Ramos L. Congenital brachymetatarsia: Three cases. Foot Ankle 1993; 14:529–533.
Fox IM. Treatment of brachymetatarsia by the callus distraction. J Foot Surg 1998; 37:391–395.
Magnan B, Bragantini A, Regis D, Bartolozzi P. Metatarsal lengthening by callotasis during the growth phase. J Bone Joint Surg Br 1995; 77:602–607.
Robinson JF, Ouzounian TJ. Brachymetatarsia: congenitally short third and fourth metatarsals treated by distraction lengthening. A case report and literature summary. Foot Ankle Int 1998; 19:713–718.
Kawashima T, Yamada A, Ueda K, Harii K. Treatment of brachymetatarsia by callus distraction (callotasis). Ann Plast Surg 1994; 32:191–199.
Levine SE, Davidson RS, Dormans JP, Drummond DS. Distraction osteogenesis for congenitally short lesser metatarsals. Foot Ankle Int 1995; 16:196–200.
Takakura Y, Tanaka Y, Fujii T, Tamai S. Lengthening of short great toes by callus distraction. J Bone Joint Surg Br 1997; 79B:955–958.
Wada A, Bensahel H, Takamura K, Fukii T, Yanagida H, Nakamura T. Metatarsal lengthening by callus distraction for brachymetatarsia. J Pediatr Orthop B 2004; 13:206–210
Shim JS, Park SJ. Treatment of brachymetatarsia by distraction osteogenesis
. J Pediatr Orthop.
Davidson RS. Metatarsal lengthening. Foot Ankle Clin. 2001;6:499–518.
Kessler I, Baruch A, Hecht O. Experience with distraction lengthening of digital rays in congenital anomalies. J Hand Surg Am. 1977;2:394–401.
Fernandez L, Yubero J, Usabiga J, et al. Congenital brachymetatarsia: three cases. Foot Ankle Int. 1993;14:529Y533.
Alter SA, Feinman B, Rosen RG. Chevron bone graft procedure for the correction of brachymetatarsia. J Foot Ankle Surg. 1995;34:200Y205.
Baek GH, Chung MS. The treatment of congenital brachymetatarsia by one-stage lengthening. J Bone Joint Surg Br. 1998;80:1040–1044.
Jimenez AL. Brachymetatarsia: a study in surgical planning. J Am Podiatry Assoc. 1979 Apr;69(4):245–51.
Kim HT, Lee SH, Yoo CI, Kang JH, Suh JT. The management of brachymetatarsia. J Bone Joint Surg Br. 2003 Jul;85(5):683–90.
Bartolomei FJ. Surgical correction of brachymetatarsia. J Am Podiatr Med Assoc. 1990;80:76–82.
Upton J, Khouri R, Ramos D, et al. Distraction lengthening for the congenitally short metatarsal bone: a case report. Foot Ankle. 1989;10:184–187.
Wakisaka T, Yasui N, Kojimoto H, et al. A case of short metatarsal bones lengthened by callus distraction. Acta Orthop Scand. 1988;59:194–196.
McGlamry ED, Cooper CT. Brachymetatarsia: a surgical treatment. J Am Podiatr Med Assoc. 1969;59:259–264.
Handelman RB, Perlman MD, Coleman WB. Brachymetatarsia: a review of the literature and case report. J Am Podiatr Med Assoc. 1986;76: 413–416.
Choi IH, Chung MS, Baek GH, Cho TJ, Chung CY. Metatarsal lengthening in congenital brachymetatarsia: one-stage lengthening versus lengthening by callotasis. J Pediatr Orthop. 1999 Sep–Oct;19(5):660–664.
Choi IH, Chung MS, Baek GH, et al. Metatarsal lengthening in congenital brachymetatarsia: one stage lengthening versus lengthening by callotasis. J Pediatr Orthop. 1999;19:660–664.
Houshian S, Skov O, Weeth RE. Correction of congenital brachymetatarsia by gradual callus distraction. Scand J Plast Reconstr Surg Hand Surg. 2002;36(6):373–375
Saxby T, Nunley JA. Metatarsal lengthening by distraction osteogenesis: a report of two cases. Foot Ankle 1992;13:536–539.
Masada K, Fujita S, Fuji T, et al. Complications following metatarsal lengthening by callus distraction for brachymetatarsia. J Pediatr Orthop. 1999;19:394–397
CrossRef PubMed Copyright information
© Hospital for Special Surgery 2010