%0 Review
%T Subacute two stage metatarsal lengthening with gradual distraction for brachymetatarsia: A consecutive case series and literature review.
%A Hung WC
%A Chen CH
%A Lin CH
%A Chen TY
%A Lo SP
%J Foot Ankle Surg
%V 29
%N 1
%D Jan 2023
%M 36328920
%F 2.84
%R 10.1016/j.fas.2022.10.006
%X <B>BACKGROUND: </B>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.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>Subacute two stage metatarsal lengthening with gradual distraction is a reliable alternative treatment for brachymetatarsia.