Application of distraction lengthening for correcting the short nail deformity in unilateral congenital brachydactyly type D
10.3760/cma.j.cn114453-20220930-00300
- VernacularTitle:应用牵张延长法矫正单侧D型短指症的短甲畸形
- Author:
Yongkang JIANG
1
;
Lei HUANG
;
Bin WANG
;
Wenhai SUN
Author Information
1. 上海交通大学医学院附属第九人民医院整复外科，上海 200011
- Keywords:
Thumb;
Brachydactyly type D;
Nail deformity;
Distraction lengthening;
Unilateral
- From:
Chinese Journal of Plastic Surgery
2023;39(2):199-204
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To describe the effect of distraction lengthening to correct nail deformity in unilateral congenital brachydactyly type D (BDD).Methods:Patients with unilateral BDD who were treated by distraction lengthening between January 2020 and December 2021 in the Department of Plastic and Reconstructive Surgery of Shanghai 9th People’s Hospital were retrospectively reviewed. A transverse osteotomy was applied on the middle diaphysis of distal phalanx, and one pin was inserted percutaneously on both sides of the osteotomy site, then a mini external fixator was installed. Distraction lengthening was performed with a slow and sustained procedure. The aesthetic and functional results were compared preoperatively and postoperatively. Patient satisfaction questionnaires were recorded.Results:35 patients were enrolled, including 12 males and 23 females, with a mean age of 29.5 years. 17 thumbs were left and 18 thumbs were right. The time for distraction lengthening was 10-17 days, and the mean time was 12.3 days. The total time for external fixator maintenance was 55-70 days, with a mean time of 61.4 days. The mean follow-up was 18.6 months. The mean thumbnail length was increased from (9.2±0.6) mm to (14.2±0.4) mm [lengthening ratio, (54.4±7.5)%] after distraction lengthening ( P<0.05). The ratio of nail length to width changed from 0.63±0.05 to 1.05±0.04 [increase ratio, (68.2±10.5)%, P<0.05], which was equal to the normal value (1.07±0.03) ( P>0.05). Meanwhile, the distal thumb length increased from (22.6±0.7) mm to (29.6±1.0) mm ( P<0.05), with a mean increase of (6.9±1.0) mm, and the increase ratio was (30.8±4.8)%. The ratio of nail length to distal thumb length changed from 0.41±0.03 to 0.51±0.02 [increase ratio, (23.6±8.3) %, P<0.05]. The thumb function was not significantly influenced ( P>0.05). 33 patients (94.3%) were very satisfied with the results. Conclusion:Short nail deformity in BDD can be corrected by distraction lengthening with a good aesthetic appearance and without functional impairment.
