[Use of Ilizarov mini-fixator in the treatment of congenital brachymetatarsia].
OBJECTIVE
The main cause of short metatarsal bones (commonly the fourth metatarsal) is premature closure of the distal epiphyseal plate. We report results of treatment of brachymetatarsia using the Ilizarov mini-fixator.


METHODS
This study included 10 patients (19 feet) with a shortened fourth (18 feet) and third metatarsal bone. We performed gradual bone lengthening using the Ilizarov mini-fixator by distraction after osteotomy of the shortened metatarsal bone.


RESULTS
Bone lengthening was effective (from 5 to 26 mm, mean lengthening 13 mm) almost without stepping out from the metatarsal formula. In terms of discomfort at walking, esthetic aspect of the foot, and shoe wearing, good clinical and cosmetic outcome was achieved. Pain as well as callosities on the plantar aspect of the foot disappeared in all patients.


CONCLUSIONS
This technique of gradual distraction by callostasis gives sufficient lengthening for the treatment of brachymetatarsia. It overcomes the disadvantages of one-stage lengthening which include a small gain in length and neurovascular damage. This method could be recommended as the procedure of choice for solving the problem of brachymetatarsia.
Tomic
S
S
Institut d'Ortopédie et Traumatologie, "Banjica", rue M. Avramovica 28, 11000 Belgrade, Yougoslavie.
Krajcinovic
O
O
Dakic
N
N
D000293:Adolescent; D000328:Adult; D001852:Bone Lengthening / Q000295:instrumentation*; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018889:Ilizarov Technique; D008297:Male; D008682:Metatarsal Bones / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D013997:Time Factors