• Sakti Prasad Das, Ram Narayan Mohanty, and Sanjay Kumar Das.
• Swami Vivekanand National Institute of Rehabilitation Training and Research, Olatpur, Bairoi, Cuttack, Orissa, India.
• Indian J Orthop. 2009 Oct 1; 43 (4): 379-82.

BackgroundMetacarpal lengthening in the hand is a new application for distraction neo-histiogenesis. Metacarpal lengthening with distraction helps in improvement in pinch function. Thumb lengthening is technically easy in comparison to other metacarpals. We present the operative treatment and post-operative outcome in nine patients with amputations and congenital anomalies.Materials And MethodsNine patients underwent distraction osteogenesis for the treatment of amputations of the hand and other congenital anomalies. The dominant right hand was operated in eight cases and the left hand in one case. There were six males and three females. Improvement of function was always the aim of surgery. Age range was between 18 and 23 years. Thumb lengthening was performed in five patients and that of the index finger in four patients. Distraction started on the fifth post-operative day at the rate of 0.25 mm/day. Sensory function and bone consolidation was assessed before fixator removal.ResultsThe mean duration of distraction was 51 days (range, 42-60 days) and the distractor was removed at a mean of 150 days (range, 140 and 160 days) and the bones were lengthened by a mean of 24 mm (range, 20-28 mm) There was improvement of function in all cases.ConclusionThe metacarpal lengthening by distraction histiogenesis in congenital and traumatic amputations is safe and simple method to improve pinch function of hand.

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