Brachymetacarpia: features and surgical treatment

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Abstract

The purpose - to study the morphofunctional changes of upper extremities in patients with brachymetacarpia. Material and methods. The results of the examination and surgical treatment by distraction osteosynthesis of six patients (10 hands, shortening of the 18-metacarpal bones) with brachymetacarpia are presented. Results. All patients noted dissatisfaction with the cosmetic state of hands and tiredness during physical activities with the hand. IV ray was shortened in 50%, V ray - in 33% of cases and III ray - in 17%. Limitation of active flexion was noted in all patients, an average flexion was 58.9 ± 7,1°. After treatment flexion increased an average on 20.5 ° (22.7%). Complications were obtained in two patients on three hands. Conclusions. Brachymetacarpia is a rare disease, the etiology of which is still unknown and requires further study. In all cases of brachymetacarpia there is a restriction of active flexion of the MCP joint of the affected ray and the indications for treatment are caused not only by a cosmetic defect, but also functional impairment. Surgical treatment of brachymetacarpia by distraction osteosynthesis gives predictably good results. Complications during the treatment of brachymetacarpia are rare and mostly related to the appearance of contractures, in order to prevent which in the postoperative period should be used preventive conservative therapy.

About the authors

V. I. Zavarukhin

Turner Scientific and Research Institute for Children’s Orthopedics

Author for correspondence.
Email: zavarukhin.md@gmail.com
Russian Federation

A. G. Baindurashvili

Turner Scientific and Research Institute for Children’s Orthopedics

Email: turner01@mail.ru
Russian Federation

A. V. Govorov

Turner Scientific and Research Institute for Children’s Orthopedics

Email: agovorov@yandex.ru
Russian Federation

References

  1. Тяжелков А.П., Работа А.И., Воловик В.Е. Ошибки при использовании метода дистракции у детей с дефектами пальцев кисти. В кн.: Материалы первого пленума ассоциации травматологов и ортопедов РФ. Самара; 1994. с. 109-111.
  2. Шведовченко И.В. Врожденные недоразвития кисти у детей [дис.. д-ра мед. наук] СПб.: НИДОИ им. Г.И.Турнера; 1993.
  3. Arslan H. Metacarpal lengthening by distraction osteogenesis in childhood brachydactyly. Acta Orthopaedica Belgica. 2001;3:242-247.
  4. Aydinlioglu A., Akpinar F., Tosun N. Mathematical relations between the lengths of the metacarpal bones and phalanges: surgical significance. The Tohoku journal of experimental medicine. 1998;3:209-216.
  5. Bell J. On brachydactyly and symphalangism. In: Penrose L.S., ed. The treasury of human inheritance. Cambridge: Cambridge University Press; 1951. Part 1. Vol. 5. p. 1-31.
  6. Bozan M.E., Altinel L., Kuru I., Maralcan G., Acar M., Durmaz H. Factors that affect the healing index of metacarpal lengthening: a retrospective study. Journal of orthopaedic surgery (Hong Kong). 2006;2:167-171.
  7. Bulut M. Lengthening by distraction osteogenesis in congenital shortening of metacarpals. Acta Orthopaedica et Traumatologica Turcica. 2013;2:79-85.
  8. Harvey F.J. Metacarpal shortening in young children following trauma. J. Bone Joint Surgery. 1976;(58): 260.
  9. Hudson L.C., Money D.W. Symmetric bilateral brachymetacarpalia of a dog. Veterinary Pathology. 1995;2:187- 189.
  10. Kato H., Minami A., Suenaga N. Callotasis lengthening in patients with brachymetacarpia. J. Pediatric Orthopaedics. 2002;4:497-500.
  11. Meunier M.J. et al. Predicted effects of metacarpal shortening on interosseous muscle function. J. Hand Surgery. 2004;4:689-693.
  12. Oh C.-W. et al. Complications of distraction osteogenesis in short fourth metatarsals. J. Pediatric Orthopedics. 2003;(4):484-487.
  13. Ridgeway S., Tai C., Singh D. A case report of brachydactyly types D and E: A new variation of brachydactyly. Foot Ankle Int. 2004;6:419-422.
  14. Schoeller T. et al. Idiopathic isolated bilaterally symmetrical brachymetacarpia of the fifth metacarpal. Case report. Scand. J. Plast. Reconstr. Surg. Hand Surg. 1998;1:117-119.
  15. Shim J.S., Park S.J. Treatment of brachymetatarsia by distraction osteogenesis. J. Pediatric Orthop. 2006;2:250-254.
  16. Southgate G.W., Holms W. Metacarpal lengthening. J. Hand Surg. Br. 1985;(3):391-392.
  17. Volpi A.D., Fragomen A.T. Percutaneous distraction lengthening in brachymetacarpia. Orthopedics. 2011;(8):424-427.
  18. Wills B.P.D. et al. The effect of metacarpal shortening on digital flexion force. J. Hand Surg. Eur. Vol. 2013;(6):667-672.

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