title: Bone lengthening for congenital differences of the hands and digits in children.
abstract: OBJECTIVE
  We investigated the growth of bones after lengthening to evaluate the effectiveness and usefulness of bone lengthening in congenital hand deficiencies.
  
  
  METHODS
  Bone lengthening was performed to treat congenital hand deficiencies including hypoplastic thumb, hypoplasia of the small finger, cleft hand, metacarpal synostosis, brachymetacarpia, symbrachydactyly, and amniotic band syndrome. A total of 15 patients (1-13 years old) underwent lengthening of 23 bones. The average of distraction was 10 mm. The mean follow-up period was 59 months. The length of the bones at follow-up evaluation was measured and then compared with the length of the bones immediately after lengthening. The bone growth after lengthening, the percentage of growth after lengthening, and the growth rate were compared among diagnostic groups.
  
  
  RESULTS
  In the cases involving older patients the bone length changed little and the growth plates of these patients closed naturally soon after lengthening. In contrast, in the cases in which the patients were younger than 7 years old the lengthened bones grew continuously. The amount of bone growth was different for each disease in the younger patients. In patients with amniotic band syndrome the lengthened bones grew at the same rate as the bones in the hand. Other diagnoses such as symbrachydactyly had a different growth pattern in the hand.
  
  
  CONCLUSIONS
  We conclude that bone lengthening is a reliable method for the correction of congenital differences of the hand. The indications for this procedure must be determined while considering the relationship between the specific disease and subsequent bone growth.
authors.affiliation: Department of Orthopaedic Surgery, Sera Central Hospital, Hongou, Sera, Hiroshima Prefecture, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Matsuno
authors.forename: Osamu
authors.initials: O
authors.lastname: Ishida
authors.forename: Toru
authors.initials: T
authors.lastname: Sunagawa
authors.forename: Makoto
authors.initials: M
authors.lastname: Ichikawa
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Ikuta
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Ochi
mesh_terms: D000293:Adolescent; D000652:Amniotic Band Syndrome / Q000601:surgery; D001846:Bone Development; D002648:Child; D002675:Child, Preschool; D005260:Female; D005385:Fingers / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D006228:Hand Deformities, Congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008663:Metacarpus / Q000254:growth & development; D019857:Osteogenesis, Distraction; D011183:Postoperative Complications / Q000209:etiology; D011184:Postoperative Period; D011859:Radiography; D013933:Thumb / Q000002:abnormalities