title: Lengthening by distraction osteogenesis in congenital shortening of metacarpals.
abstract: OBJECTIVE
  The aim of this study was to present the results of seven cases of metacarpal lengthening by distraction osteogenesis and to discuss the ideal daily rate of distraction.
  
  
  METHODS
  Metacarpal lengthening was performed by distraction osteogenesis in the seven metacarpals of four patients (3 females, 1 male; mean age: 14.9 years). A unilateral external fixator was used for lengthening. Lengthening was initiated with a distraction rate of 2x0.5 mm/day in the patient with bilateral involvement of the middle and ring metacarpals. On the tenth day of lengthening, distraction was discontinued due to pain and contracture. Then, distraction was continued with a rate of 2x0.25 mm/day. In all other cases, the distraction rate was 0.5 mm/day. Pre- and postoperative range of motion was measured with a goniometer. Patient satisfaction was evaluated with visual analog scale.
  
  
  RESULTS
  The mean pre- and postoperative metacarpal lengths were 34.6 mm (range: 33 to 37) and 49.7 mm (range: 47 to 52), respectively. The mean lengthening achieved was 15.1 mm (range: 14 to 17), while the mean distraction rate was 0.55 mm/day (range: 0.48 to 0.63). No functional loss was observed in the fingers at the final check-up. The patients were happy with the functional and cosmetic results.
  
  
  CONCLUSIONS
  Distraction osteogenesis is a safe method providing acceptable cosmetic and functional results in patients with congenital metacarpal shortness. The length of metacarpals and muscles that will be affected from lengthening should be considered when determining the daily rate of distraction.
authors.affiliation: Department of Orthopedics and Traumatology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey. bulmeh@yahoo.com
authors.forename: Mehmet
authors.initials: M
authors.lastname: Bulut
authors.forename: Bekir Yavuz
authors.initials: BY
authors.lastname: Uçar
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Azboy
authors.forename: Oktay
authors.initials: O
authors.lastname: Belhan
authors.forename: Erhan
authors.initials: E
authors.lastname: Yilmaz
authors.forename: Lokman
authors.initials: L
authors.lastname: Karakurt
mesh_terms: D000293:Adolescent; D016267:External Fixators; D005260:Female; D005384:Finger Joint / Q000503:physiopathology; D006801:Humans; D008297:Male; D050279:Metacarpal Bones / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery*; D019857:Osteogenesis, Distraction; D010147:Pain Measurement; D017060:Patient Satisfaction; D011859:Radiography; D016059:Range of Motion, Articular