Problems in the Treatment of Brachymetatarsia by Callotasis

Kim, Woo Jung; Kwon, Sung Tack

Abstract

We performed 34 metatarsal distraction lengthenings in 17 patients for the treatment of brachymetatarsia from May 1994 to December 2001. The average amount of lengthening was 15.6 mm(35.9%), range: 10.1 - 22.9 mm(18.8 - 64.1%). The average healing index was 75 days/cm(range, 49 - 119 days/cm). Complications included five cases of pin site infection, 3 cases of under-correction and 1 case of plantar angulation. All the pin site infections were well responded to oral antibiotics, but reduced the lengthening speed. In two cases, the early removal of fixator resulted in under-correction. The early removal was occurred by either patient's impatience to wear fixator or physician's hasty. In one case, it was not possible to distract because of the osteoporotic change of osteotomized segment during distraction. Plantar angulation of first metatarsal resisted to bone remodeling was corrected by wedge osteotomy. The expected joint stiffness was not paid any attention in all cases. Non-union, fracture and any neuovascular complications were not observed. We have found that the metatarsal lengthening by callotasis under the close physician's supervision of those problems, especially plantar angulation of first metatarsal, is safe and reliable procedure.