title: Treatment of Complications after Distraction Osteogenesis for Brachymetatarsia of the Fourth Metatarsal.
abstract: Congenital brachymetatarsia most commonly involves the fourth ray and may be combined with metacarpal shortening. Numerous reports have demonstrated the usefulness of gradual lengthening of the metatarsals. However, very few studies have investigated methods of recovering the lost regenerative bone. The patient was a 16-year-old girl with bilateral brachymetatarsia of the fourth metatarsal. After a long consolidation period after gradual lengthening of the fourth metatarsal by 20 mm, the patient had an hourglass-shaped regenerated bone. Therefore, we grafted a bioabsorbable hydroxyapatite and collagen composite. Six months after the surgery, well-regenerated bone could be recognized on radiographic evaluation and was resistant to refracture. Callus distraction is a method that aims to avoid donor site morbidity. The strength of artificial bone is often a problem. Bioabsorbable hydroxyapatite and collagen composite compensates for the lack of regenerated bone and distraction gap and prevents refracture, thus preventing complications after metatarsal distraction.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan; and Department of Plastic and Reconstructive Surgery, Kagawa University School of Medicine, Kita-gun, Kagawa Prefecture, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Hamada
authors.affiliation: Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan; and Department of Plastic and Reconstructive Surgery, Kagawa University School of Medicine, Kita-gun, Kagawa Prefecture, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Sakamoto
authors.affiliation: Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan; and Department of Plastic and Reconstructive Surgery, Kagawa University School of Medicine, Kita-gun, Kagawa Prefecture, Japan.
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Nagasao
authors.affiliation: Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan; and Department of Plastic and Reconstructive Surgery, Kagawa University School of Medicine, Kita-gun, Kagawa Prefecture, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kishi