DISTRACTION LENGTHENING FOLLOWING GROWTH CESSATION DUE TO THUMB REPLANTATION IN A CHILD

Growth disturbance due to premature physeal closure as a sequela of di git replantation, on occasion, can cause shortening, resulting in subo ptimal function, A simple method for correction using only local tissu es is possible via gradual bony distraction. This was attempted in a t oddler, whose dominant thumb was amputated by a riding lawn mower when he was an infant, because replantation caused significant growth cess ation. The first metacarpal distraction over 64 days netted 22 mm of l engthening. Because a further immobilization period to allow spontaneo us consolidation by neo-osteogenesis was aborted at the family's insis tence, a fibular autograft of that dimension was inserted into the cre ated bony gap. Ultimately, after 24 months of follow-up, the distracte d thumb had been increased 26% in length and was 88% of the length of the contralateral thumb at that time, compared to only 74% prior to in itiating the distraction.