Modified step-cut osteotomy for metacarpal and phalangeal rotational deformity.
OBJECTIVE
Rotational deformity of metacarpal and phalangeal fractures can jeopardize normal hand function and cause aesthetic problems for patients. We have found the Z-cut metacarpal osteotomy, initially described by Manktelow, to prove predictable and provide precise restoration of rotation and function. Therefore, we reviewed our experience with this technique.


METHODS
The senior authors identified 12 patients treated with rotational step-cut osteotomies for digital rotatory deformities. The cases were reviewed retrospectively. Seven had metacarpal and five had phalangeal malunions.


RESULTS
All 12 patients had correction of their deformities, obtained union of the osteotomy, and maintained or improved their motion. There were no perioperative complications.


CONCLUSIONS
Metacarpal step-cut osteotomies are a technically simple and effective method for correction of digital rotational deformities resulting from fracture malunions. Unlike other types of osteotomies, this technique affords precise intraoperative control at the osteotomy site, a large surface area for bony healing, and rigid fixation with early digital motion.
Jawa
Andrew
A
Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA 02114, USA. ajawa@partners.org
Zucchini
Maura
M
Lauri
Guilio
G
Jupiter
Jesse
J
D000293:Adolescent; D000328:Adult; D017760:Bone Malalignment / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D050278:Finger Phalanges / Q000293:injuries* / Q000601:surgery; D017759:Fractures, Malunited / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D050279:Metacarpal Bones / Q000293:injuries* / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D012399:Rotation