The treatment of congenital brachymetatarsia by one-stage lengthening

We performed one-stage lengthening using intercalary autogenous hone graft in 34 metatarsals and seven proximal phalanges in 21 patients with congenitally short metatarsals, At operation, in order to decrease the tension in the surrounding soft tissues, we gradually distracted the osteotomies of the affected hones for 20 to 30 minutes. The patients, all women, were followed up fur a mean period of 2.1 years (1 to 6.5). The average gain in length for the 34 metatarsal procedures was 14 mm (6 to 21), equivalent to an increase of 32% (11 to 51), and for the seven proximal phalangal lengthenings 8 mm (5 to Pi), an increase of 54% (47 to 65). These was no evidence of neurovascular impairment. The technique of gradual distraction during operation is simple and effective. It overcomes the disadvantages of one-stage lengthening such as a small gain in length and neurovascular damage.