Abstract
Aims: In reconstruction of brachydactyly, either post-traumatic or congenital, we present our method of skeletal lengthening by distraction. Methods: We treated 32 short digits in 15 patients. Posttraumatic: 10patients and Congenital shortening: 5patients (Average age 5years (3.4 – 7.7 years) in congenital group). For traumatic amputation duration between injury and surgery: average 14weeks (10–19.5weeks). Concerned phalanx exposed through dorsal approach. Transfixing k-wires passed perpendicular to phalangeal shaft above and below proposed osteotomy and connected on either side to a distractor. Latency period: 5days. Distraction rate: 0.8 mm/day. Serial x-rays at 3weekly intervals. In 6patients with deficient new bone, bone grafting was done using iliac crest graft. Fixator left in situ till radiological evidence of bony healing than wires removed under local anaesthesia and patients were started on vigorous physiotherapy for gaining range of movements. 8patients required deepening of the web space in addition to above-mentioned procedures. This procedure was required in cases having more than one short digit. Results: Average length gained: 18mm. Average duration of distraction: 42.26days. Fixator in situ: average 92days (80–136days). Initial stiffness of digits was seen in 50% of cases, which eventually responded to physiotherapy, & all patients had an excellent range of motion. Conclusions: This method provides patients with good function and cosmetic hand. Any surgeon not familiar with microvascular surgery can use this technique.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
