SURGICAL TREATMENT OF METACARPAL SYNOSTOSIS IN CHILDREN

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Abstract

Objective: to develop the surgical treatment of patients with congenital metacarpal synostosis. Material and methods. 65 operations were performed in 58 children. with congenital metacarpal synostosis. Surgical intervention was determined by the localization of congenital metacarpal synostosis and the presence of concomitant deformities. Results. Excellent and good results were observed in 69,4% (33 hands) cases, satisfactory - in 30,6% (15 hands), unsatisfactory results were not obtained. At the same time excellent results were obtained in patients with less severe variants of metacarpal synostosis, good treatment results were observed in children with more severe associated abnormalities, as well as in cases where the correction is not performed metacarpal shortening. Overall, the results were significantly (p <0,05) better after application of advanced methods, including correction of all components of the strain. Satisfactory results were found out in patients with severe comorbidity, a total fusion of the metacarpal bones and fingers, the total PPS. Conclusions. Surgical treatment options for all congenital metacarpal synostosis should be individualized and be concluded in the performance of bone and plastic surgery to remove metacarpal synostosis and related deformities.

About the authors

A. V. Zaletina

Turner Scientific and Research Institute for Children's Orthopedics

Author for correspondence.
Email: anna-d7@yandex.ru
Russian Federation

References

  1. Пат. 2373880 РФ, МПК А61В 17/56 Способ реконструкции кисти при врожденной конкресценции центральных пястных костей у детей. Голяна С.И., Агранович О.Е., Дьяченко А.В. Заявитель и патентообладатель ФГУ НИДОИ им. Г.И. Турнера. № 2008121301/14; заявл. 27.05.2008; опубл. 27.11.2009, Бюл. № 33.
  2. Шведовченко И.В. Врожденные недоразвития кисти у детей [дис. ... д-ра мед. наук]. СПб.: НИДОИ им. Г.И. Турнера; 1993.
  3. Buck-Gramcko D, Wood V.E. The treatment of metacarpal synostosis. J. Hand Surg. Am. 1993;18(4):565-581.
  4. Buckwalter J.A., Flatt A.E., Shurr D.G., Dryer R.F., Blair W.F. The absent fifth metacarpal. J. Hand Surg. Am. 1981;6(4):364-367.
  5. Foucher G., Navarro R., Medina J., Khouri R.K. Metacarpal synostosis: a simple classification and a new treatment technique. Plast. Reconstr. Surg. 2001;108(5):1225-1231;
  6. Guero S.J. Algorithm for treatment of apert hand. Tech. Hand Up. Extrem. Surg. 2005;9(3):126-133.
  7. Hikosaka K., Yabe Y. Treatment for fourth and fifth metacarpal synostosis with abduction deformity of little finger. In: Proc. Ann. Meet. Jpn. Soc Surg. Hand. 1981. p. 66-68.
  8. Hooper G., Lamb D.W. Congenital fusion of the little and ring finger metacarpal bones. Hand. 1983;15(2):207-211.
  9. Horii E., Miura T., Nakamura R., Nakao E., Kato H. Surgical treatment of congenital metacarpal synostosis of the ring and little fingers. J. Hand Surg. Br. 1998;23(5):691-694.
  10. Jianmongkol S., Thammaroj T., Vipulakorn K. Congenital metacarpal synostosis treated by double bone blocks technique: a case report from Thailand. Hand Surg. 2005;10(1):131-4.
  11. Iwasawa M., Hayashi R., Matsuo K., Hirose T. The use of costal cartilage as a spacer in the treatment of congenital metacarpal fusion. Eur. J. Plast. Surg. 1988;11:138-142.
  12. Kawabata H., Yasui N., Che Y.H., Hirooka A. Treatment for congenital synostosis of the fourth and fifth metacarpals with the hemicallotasis technique. Plast. Reconstr. Surg. 1997;99(7):2061-2065.
  13. Licznerski A. Possibilities of surgical treatment of syndactyly associated with developmental anomalies of the phalanges and metacarpal bones. Chir. Narzadow Ruchu Ortop. Pol. 1975;40(4):521-526.
  14. Miura T. Congenital synostosis between the fourth and fifth metacarpal bones. J. Hand Surg. Am. 1988;13(1):83-88.
  15. Ogino T., Kato H. Clinical features and treatment of congenital fusion of the small and ring finger metacarpals. J. Hand Surg. Am. 1993;18(6):995-1003.
  16. Paneva-Holevich E., Yankov E. A distraction method for lengthening of the finger metacarpals: a preliminary report. J. Hand Surg. Am. 1980;5(2):160-167.
  17. Ueba Y., Seto Y. Congenital metacarpal synostosis treated by longitudinal osteotomy and placement of a silicone wedge. Handchir. Mikrochir. Plast. Chir. 1997;29(6):297-302.
  18. Wood, V.E. Metacarpal synostosis. In: Operative hand surgery. New York: Churchill Livingstone; 1993. 674 p.
  19. Yamamoto N., Endo T., Nakayama Y. Congenital synostosis of the fourth and fifth metacarpals treated by free bone grafting from the fusion site. Plast. Reconstr. Surg. 2000;105(5):1747-1750.
  20. Yildirim S., Akan M., Akoz T. Phalangeal osteotomy for the treatment of metacarpal synostosis: a case report. Hand Surg. 2003;8(1):87-91.

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