Cengiz ŞEN, Mehmet KOCAOĞLU, Levent ERALP, Murat ÇINAR

Doğuştan metakarp ve metatars kısalıklarının kallus distraksiyonu yöntemi ile uzatılması

Amaç: Doğuştan metakarp ve metatars kısalıklarında uyguladığımız kallus distraksiyonu ile elde edilen sonuçlar değerlendirildi. Çalışma planı: Doğuştan dördüncü metakarp ve metaıars kısalığı olan beş hastada (4 kız, 1 erkek; ört. yaş 15; dağılım 10-21) kallus distraksiyonu yöntemi ile yedi metakarp ve dört metatars uzatıldı. Kallus distraksiyonu, mini-Ortho-fix ve Ilizarov tipi semisirküler eksternal fiksatör kullanılarak yapıldı. Her iki fıksatörde de uzatma hızı 0.25x2 mm/gün olarak uygulandı. Ortalama takip süresi 23 ay (da-ğılım 12-38 ay) idi. Sonuçlar: Ortalama uzatma miktarları metakarpta 20 mm (dağılım 15-25 mm), metatarsta 25 mm (20-30 mm) olarak saptandı. İyileşme indeksi metakarp uzatma için 1.4 ay/cm, metatars uzatma için 1.8 ay/cm bulundu. Hiçbir hastada nörovasküler yaralanmaya rastlanmadı. Kaynama elde etmek için bir hastada otojen fibula grefti kullanıldı. Üç hastada çivi dibi enfeksiyonu görüldü. Komplikasyon oranı %36 bulundu. Çıkarımlar: Kallus distraksiyonu, birçok kemiğin yanı sıra metakarp ve metatars gibi kısa kemiklerin uzatılmasında da etkili ve güvenilir bir yöntemdir. Ayrıca, osteotomi sırasın-da periostun korunması tedavi süresini kısaltmaktadır.

Anahtar Kelimeler:

Radyografi, Eksternal fiksatörler, Metakarpus, Kemik uzatma, Çocuk, Ilizarov tekniği

Bone lengthening of congenitally short metacarpus and metatarsus by the callus distraction technique

Objectives: We evaluated the results of lengthening of congenitally short metacarpus and metatarsus by the callus distraction technique. Methods: We treated congenitally short metacarpus (n=7) and metatarsus (n=4) of five patients (4 females, 1 male; mean age 15 years; range 10 to 21 years) by callotasis. Callus distraction was performed with the use of mini-Orthofix or Ilizarov type semicircular external fixators. The distraction rate was 0.25x2 mm/day for both types. The mean follow-up period was 23 months (range 12 to 33 months). Results: The mean metacarpal and metatarsal lengthenings were 20 mm (range 15 to 25 mm) and 25 mm (range 20 to 30 mm), respectively. The mean healing index was 1.4 months/cm for metacarpal lengthening, and 1.8 months/cm for metatarsal lengthening. No neurovascular complications were encountered. One patient required autogenous fibular grafting for union. Pin tract infections were found in three patients. The overall complication rate was 36%. Conclusion: Callotasis is an effective and reliable method for lengthening of short metacarpal and metatarsal bones. In addition, it preserves the periosteal bone tissues, which has a favorable effect on the duration of treatment.

Keywords:

Radiography, External Fixators, Metacarpus, Bone Lengthening, Child, Ilizarov Technique,

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