title: Metacarpal lengthening in children: comparison of three different techniques in 15 consecutive cases.
abstract: Metacarpal lengthening is a useful procedure to address hand deficiencies in children. In this study, we aimed to compare the results of three different techniques from one consecutive clinical series of hand deficiencies. A total of 15 metacarpal lengthenings have been performed in 12 children aged from 9 to 14 years. The callotasis technique was used in seven cases, the two-stage distraction-graft technique in four cases and the single-stage lengthening in four cases. All the metacarpals healed with bone. The lengthening obtained was a mean of 13 mm (range 8-21 mm), a mean of 22 mm (range 13-32 mm) and a mean of 12 mm (range 9-15 mm), respectively, in the three different techniques. The healing index was longer for callotasis (81 days/cm) compared with the other techniques (41 days/cm and 46 days/cm, respectively). We observed one case of fracture after callotasis and one after distraction-graft. One patient underwent tenolysis of the extensor mechanism after single-stage lengthening. In conclusion, distraction graft and single-stage lengthening may be valuable alternatives to callotasis.
  
  
  METHODS
  IV; therapeutic study; multi-case series.
authors.affiliation: Department of Orthopaedic Paediatrics, Necker-Enfants-Malades Hospital, Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Dana
authors.affiliation: Department of Orthopaedic Paediatrics, Necker-Enfants-Malades Hospital, Paris, France.
authors.forename: J-C
authors.initials: JC
authors.lastname: Aurégan
authors.affiliation: Department of Orthopaedic Paediatrics, Necker-Enfants-Malades Hospital, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Salon
authors.affiliation: Department of Orthopaedic Paediatrics, Necker-Enfants-Malades Hospital, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Guéro
authors.affiliation: Department of Orthopaedic Paediatrics, Necker-Enfants-Malades Hospital, Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Glorion
authors.affiliation: Department of Orthopaedic Paediatrics, Necker-Enfants-Malades Hospital, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Pannier
keywords: Metacarpal lengthening; callotasis; single-stage lengthening; two-stage distraction-graft