Ilizarov technique for treatment of congenital brachymetatarsia of the fourth: subgroup analysis of prolongation ratio

doi:10.12307/2025.821

Abstract

Abstract: BACKGROUND: The Ilizarov technique is very effective in the treatment of congenital brachymetatarsia of the fourth, but there are still some complications. The optimal proportion of lengthening of the fourth metatarsal is still controversial.
OBJECTIVE: To explore the clinical efficacy of Ilizarov technique in the treatment of congenital brachymetatarsia of the fourth and the optimal lengthening ratio.
METHODS: Medical records of patients with congenital brachymetatarsia of the fourth treated with Ilizarov technique in Guangdong Provincial Hospital of Traditional Chinese Medicine from August 2021 to October 2023 were collected. American Orthopaedic Foot and Ankle Society scores before and after the treatment, length of the fourth metatarsal before and after surgery, and postoperative complications were evaluated. The prolongation ratio was analyzed by subgroups to assess the best suitable length for the operative conditions.
RESULTS AND CONCLUSION: (1) A total of 16 patients were included. The length of the fourth metatarsal before treatment was (43.51±3.75) mm, and the shortening length was (12.53±2.82) mm; the lengthening time during the treatment period was (36.95±4.12) days, and the time with external fixation bracket was (102.30±32.74) days, and the lengthening length after the treatment was (13.90±3.47) mm, and the prolongation ratio was (32.30±9.10)%. (2) American Orthopaedic Foot and Ankle Society scores were significantly increased at the last follow-up compared with that before treatment (t=0.763, P < 0.01). (3) The main postoperative complications were bone nonunion, metatarsophalangeal joint dislocation, metatarsophalangeal joint narrowing, and excessive lengthening of the fourth metatarsal. All patients were free of infection and abnormal sensation in the toe. (4) Subgroup analysis based on prolongation ratio showed that the rate of complications in patients in the prolongation ratio ≤ 35.36% group (17%) was significantly lower than the prolongation ratio > 35.36% group (100%) (t=14.008, P < 0.01). Meanwhile, the postoperative American Orthopaedic Foot and Ankle Society score of patients in the prolongation ratio ≤ 35.36% group (90.25±3.01) was higher than that of patients in the prolongation ratio >35.36% group (82.00±9.97) (t=2.254, P=0.037). (5) It is concluded that Ilizarov technique for the treatment of congenital brachymetatarsia of the fourth is less traumatic surgery, can significantly improve the foot deformity of patients, especially suitable for the treatment of patients whose prolongation ratio does not exceed 35.36%, with low complication rate and satisfactory results.

Key words: Ilizarov technique, brachymetatarsia of the fourth, metatarsal lengthening, prolongation ratio, complication, orthopedic implant

CLC Number:

Liang Jiachang, Guan Hua, Feng Enhui, Chen Pu, Huang Weiming, He Jianbo, Xie Jiewei. Ilizarov technique for treatment of congenital brachymetatarsia of the fourth: subgroup analysis of prolongation ratio[J]. Chinese Journal of Tissue Engineering Research, 2025, 29(33): 7217-7222.

Figures/Tables 5

References

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