Brachymetatarsia is considered to be caused by early fusion of the epiphyseal line and it is most commonly found in the fourth metatarsus. Since it is often observed in the fourth toe in women, it is treated to achieve improvement from an aesthetic aspect. We have devised a new metatarsal lengthening operation for brachymetatarsia by a hydroxyapatite graft. First, a full-scale model of the bilateral fourth metatarsi was prepared using three dimensional computed tomography (3D CT) data. Based on this model, a spacer, 10 mm in length, was prepared using hydroxyapatite with a 15 % porosity rate. At present, 3 years have passed since the operation on the left foot, and 2 years and 8 months after the operation, good morphology with no pain or tylomas has been maintained. In X-ray examinations, callus formation has progressed and the metatarsal alignment is good. Since many patients are young women, this method has many advantages as follows: donors are not needed, one-point lengthening is possible, shortening due to postoperative bone resorption does not occur, bone alignment is not damaged, and the time until start of walking is short. Level of Evidence: Level V, therapeutic study.
European Journal of Plastic Surgery – Springer Journals
Published: Jan 1, 2013
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