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Accordion technique based on mini monolateral external fixator in treatment of congenital brachymetatarsia |
NIE Shaobo1, WU Taoguang1, HAO Ming1, WANGKun1, JI Hui2, ZHANG Qun1 |
1. Department of Orthopedics, China; 2. Anesthesia Surgery Center, the First Medical Center of PLA General Hospital, Beijing 100853,China |
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Abstract Objective To explore the clinical effects of accordion technique based on mini monolateral external fixator in the treatment of congenital brachymetatarsia. Methods Retrospective analysis of 25 patients with brachymetatarsia treated by a same surgeon from Jan 2009 to May 2019, with a mean age of 24 years(from 18 to 34 years) was conducted. All patients were fixed with a monolateral external fixator and the metatarsal was lengthened by accordion technique. Postoperative early full range exercise of metatarsophalangeal joints was conducted to avoid joint stiffness And the functional evaluation was performed at the last follow-up. Results Surgery and the follow-up were completed for all patients. Follow-up ranged from 9 to 56 months with an average of 24 months. The length area of metatarsal was healed without complications. The mean length of distraction was 15 mm and the healing index was 61.8 day/cm. The postoperative metatarsophalangeal joint had a smaller range of motion than the preoperative (90.5° vs. 85.0°, t=1.983,P=0.061) but the functional scores were better than preoperative (82.5 vs. 92.1, t=-5.892,P<0.001). Nail infection occurred in 2 metatarsal bones and the complication rate was 8% without serious complications such as fractures. Conclusions Accordion technique is a reliable option in treating brachymetatarsia because of its good osteogenesis quality, less stiffness of metatarsophalangeal joint, good postoperative function and less complications.
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Received: 20 January 2022
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