Six lesser metatarsal lengthening procedures were performed in three patients using a miniature external fixator to perform distraction osteogenesis. The metatarsals were lengthened an average of 15.5 mm. The external fixator was left in place for an average of 15.5 weeks, with additional time in a cast or cast shoe.
Complications included five occurrences of infection, two cases of premature healing of the osteotomy, one nondisplaced fracture through the new bone formation, and hypertrophic granulation at a pin site. While all metatarsals were successfully lengthened, two rays (one patient) had symptomatic stiffness at the metatarsophalangeal joint with continued metatarsalgia.
. FischerF.J.VandemarkR.E.: Bilateral symmetrical brachymetacarpalia and brachymetatarsia: report of a case. J. Bone Joint Surg., 27A: 145, 1945
3.
. GreenfieldG.B.: Radiology of Bone Diseases. Philadelphia, J.B. Lippincott Co., 1975, p. 285
4.
. IlizarovG.A.: The tension-stress effect on the genesis and growth of tissues: Part I. The influence of stability of fixation and soft tissue preservation. Clin. Orthop., 238: 249–281, 1989.
5.
. IlizarovG.A.: The tension-stress effect on the genesis and growth of tissues: Part II. The influence of the rate and frequency of distraction. Clin. Orthop., 239: 263–285, 1989
6.
. IlizarovG.A.: Clinical application of the tension-stress effect for limb lengthening. Clin. Orthop., 250: 8–26, 1990.
7.
. KaplanE.G.KaplanG.S.: Metatarsal lengthening by use of autogenous bone graft and internal wire compression fixation: a preliminary report. J. Foot Surg., 17: 60–66, 1978
8.
. KelikianH.ClaytonL.LoseffH.: Surgical syndactylia of the toes. Clin. Orthop., 19: 208–231, 1961
9.
. KiteJ.H.: The Clubfoot. New York, Grune and Stratton, 1964, p. 156
10.
. MahK.K.S.BeegleT.R.FalknorD.W.: A correction for short fourth metatarsal. J.A.P.A., 73: 196–200, 1983.
11.
. McGlamryE.D.CooperC.T.: Brachymetatarsia: a surgical treatment. J.A.P.A., 59: 259–264, 1969.
12.
. MercadoO.A.: An atlas of foot surgery. Forefoot Surgery, Vol. 1. Chicago, Carolando Press, 1979, p. 108
13.
. NogarinL.MagnanB.BragantiniA.MolinaroliF.: The surgical correction of metatarsal dysmetria. Ital. J. Orthop. Trauma, 14: 77–80, 1988.
14.
. PageJ.C.DockeryG.L.VanceC.E.: Brachymetatarsia with brachymesodactyly. J. Foot Surg., 22: 104–107, 1983.
15.
. SaxbyT.NunleyJ.A.: Metatarsal lengthening by distraction osteogenesis: a report of two cases. Foot Ankle, 13: 536–539, 1992.
16.
. ScheinerD.E.ChamasC.E.: Brachymetatarsia: a review and case study. J. Foot Surg., 22: 257–262, 1983.
17.
. UranoY.KobayashiA.: Bone lengthening for shortness of the fourth toe. J. Bone Joint Surg., 60A: 91–93, 1978.
18.
. WakisakaT.YasuiN.KojimotoH.TakasuM.ShimomuraY.: A case of short metatarsal bones lengthened by callus distraction. Acta Orthop. Scand., 59: 194–196, 1988.
