Metacarpal lengthening in children: comparison of three different techniques in 15 consecutive cases

摘要

Metacarpal lengthening is a useful procedure to address hand deficiencies in children. In this study, we aimed to compare the results of three different techniques from one consecutive clinical series of hand deficiencies. A total of 15 metacarpal lengthenings have been performed in 12 children aged from 9 to 14years. The callotasis technique was used in seven cases, the two-stage distraction-graft technique in four cases and the single-stage lengthening in four cases. All the metacarpals healed with bone. The lengthening obtained was a mean of 13mm (range 8-21mm), a mean of 22mm (range 13-32mm) and a mean of 12mm (range 9-15mm), respectively, in the three different techniques. The healing index was longer for callotasis (81days/cm) compared with the other techniques (41days/cm and 46days/cm, respectively). We observed one case of fracture after callotasis and one after distraction-graft. One patient underwent tenolysis of the extensor mechanism after single-stage lengthening. In conclusion, distraction graft and single-stage lengthening may be valuable alternatives to callotasis. Level of evidence: IV; therapeutic study; multi-case series