Abstract：
BACKGROUND: This study examined the functional and clinical outcomes of subacute two stage metatarsal lengthening with gradual distraction for brachymetatarsia. This technique was developed to overcome the disadvantages of one-stage metatarsal lengthening and gradual distraction.
METHODS: Four feet of three patients with congenital brachymetatarsia underwent subacute two stage metatarsal lengthening with gradual distraction. Pain, function, and alignment were assessed preoperatively and at follow-ups using the American Orthopaedic Foot and Ankle Society (AOFAS) lesser metatarsophalangeal-interphalangeal scale, and any complications were recorded.
RESULTS: The patients were followed up for a mean of 18.1 ± 6.9 (range, 12.6-28.1) months. The mean metatarsal length gain was 15.2 ± 3.2 (range, 12.1-18.5) mm, and the corresponding percent increase was 32.5 % ± 7.0 % (range, 25.7-41.1 %). The mean AOFAS score (0-100) was 97.5 ± 5.0 at the final follow-up. The external fixator index was 10.2 ± 1.5 (range, 8.1-11.6) days/cm. None of the patients experienced metatarsophalangeal stiffness, subluxation or dislocation of the metatarsophalangeal joint, loss of correction, pin tract infection, delayed union, nonunion, or angular deformities.
CONCLUSIONS: Subacute two stage metatarsal lengthening with gradual distraction is a reliable alternative treatment for brachymetatarsia.
METHODS: Four feet of three patients with congenital brachymetatarsia underwent subacute two stage metatarsal lengthening with gradual distraction. Pain, function, and alignment were assessed preoperatively and at follow-ups using the American Orthopaedic Foot and Ankle Society (AOFAS) lesser metatarsophalangeal-interphalangeal scale, and any complications were recorded.
RESULTS: The patients were followed up for a mean of 18.1 ± 6.9 (range, 12.6-28.1) months. The mean metatarsal length gain was 15.2 ± 3.2 (range, 12.1-18.5) mm, and the corresponding percent increase was 32.5 % ± 7.0 % (range, 25.7-41.1 %). The mean AOFAS score (0-100) was 97.5 ± 5.0 at the final follow-up. The external fixator index was 10.2 ± 1.5 (range, 8.1-11.6) days/cm. None of the patients experienced metatarsophalangeal stiffness, subluxation or dislocation of the metatarsophalangeal joint, loss of correction, pin tract infection, delayed union, nonunion, or angular deformities.
CONCLUSIONS: Subacute two stage metatarsal lengthening with gradual distraction is a reliable alternative treatment for brachymetatarsia.
摘要：
背景：本研究检查了亚急性两阶段跖骨延长并逐渐分散治疗短肢的功能和临床结果。该技术的开发是为了克服一阶段meta骨延长和逐渐分散的缺点。
方法：对3例先天性短肢meta骨畸形患者的四足进行了亚急性两阶段and骨延长，并逐渐分散。疼痛,函数,术前和随访时使用美国骨科足踝协会（AOFAS）较小的meta趾-指间量表进行评估，并记录任何并发症。
结果：患者获得随访，平均18.1±6.9（范围，12.6-28.1）个月。平均meta骨长度增加为15.2±3.2（范围，12.1-18.5)mm,相应的百分比增加为32.5%±7.0%(范围，25.7-41.1%）。最终随访时AOFAS平均评分（0-100）为97.5±5.0。外固定器指数为10.2±1.5（范围，8.1-11.6）天/厘米。所有患者均未出现meta趾僵硬，meta趾关节半脱位或脱位，损失校正，针道感染,延迟工会，骨不连,或角畸形。
结论：亚急性两阶段跖骨延长并逐渐牵张是一种可靠的替代治疗方法。
方法：对3例先天性短肢meta骨畸形患者的四足进行了亚急性两阶段and骨延长，并逐渐分散。疼痛,函数,术前和随访时使用美国骨科足踝协会（AOFAS）较小的meta趾-指间量表进行评估，并记录任何并发症。
结果：患者获得随访，平均18.1±6.9（范围，12.6-28.1）个月。平均meta骨长度增加为15.2±3.2（范围，12.1-18.5)mm,相应的百分比增加为32.5%±7.0%(范围，25.7-41.1%）。最终随访时AOFAS平均评分（0-100）为97.5±5.0。外固定器指数为10.2±1.5（范围，8.1-11.6）天/厘米。所有患者均未出现meta趾僵硬，meta趾关节半脱位或脱位，损失校正，针道感染,延迟工会，骨不连,或角畸形。
结论：亚急性两阶段跖骨延长并逐渐牵张是一种可靠的替代治疗方法。
