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 congenit ally short metatarsals, At operation, in order to decrease the tension in t he surrounding soft tissues, we gradually distracted the osteotomies of the affected hones for 20 to 30 minutes. The patients, all women, were followe d 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 proxim al phalangal lengthenings 8 mm (5 to Pi), an increase of 54% (47 to 65). Th ese was no evidence of neurovascular impairment. The technique of gradual distraction during operation is simple and effecti ve. It overcomes the disadvantages of one-stage lengthening such as a small gain in length and neurovascular damage.