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Distraction lengthening by callotasis in the hand

Department of Orthopaedic Surgery, Hirosaki University School of Medicine, Zaifu-cho 5, Hirosaki, Aomori 036-8562, Japan.

K. Nakashima, MD, Chief of Hand Division

Department of Orthopaedic Surgery, Hirosaki Memorial Hospital, Sakai-zeki Aza-Nishida 59-1, Hirosaki, Aomori 036 8076, Japan.

K. Tsubo, MD, Chief of Department

Department of Orthopaedic Surgery, Aomori City Hospital, Katsuta-cho 1-14-20, Aomori, Aomori 030-0821, Japan.

Correspondence should be sent to Dr S. Toh.

The clinical results of 26 digits (18 patients) lengthened by distraction callotasis were evaluated and the factors which influenced healing were analysed. There were 14 men and four women, with a mean age of 39 years. All digits had suffered traumatic amputation. There were eight thumbs and 18 fingers. The level of the site of the osteotomy was at the proximal metaphysis in ten, the middle diaphysis in 13 and the distal metaphysis in three.

Although the proposed length was achieved in 23 of the 26 digits, five required additional bone grafts. The rate of healing was 96 days/cm in the digits without complications such as callus fracture or poor callus formation, and 158 days/cm in those with complications. Lengthening at the proximal metaphysis gave a better result than at the diaphysis or distal metaphysis.