• Thepparat Kanchanathepsak, Hiroyuki Gotani, Yoshitaka Hamada, Yoshitaka Tanaka, Kosuke Sasaki, Hirohisa Yagi, Yutaka Kubota, and Tulyapruek Tawonsawatruk.
• Hand and Microsurgery Center, Osaka Ekisaikai Hospital of Japan Seafarers and Relief Association, Osaka, Japan; Hand and Microsurgery Unit, Department of Orthopaedics, Faculty of Medicine Ramathibodi hospital, Mahidol University, Bangkok, Thailand.
• Injury. 2020 Dec 1; 51 (12): 2966-2969.

BackgroundBone distraction lengthening has been used for hand reconstruction. The healing process involved in this technique is affected by many factors. Here, the effectiveness and rates of healing of the phalanges and the metacarpals were evaluated in cases of traumatic finger amputation treated using an Ilizarov mini-fixator.MethodsFourteen phalanges and twelve metacarpals in 15 patients (13 males and 2 females) were treated with distraction lengthening using an Ilizarov mini-fixator between 2014 and 2017. All the digits had been subjected to traumatic amputation, and shortening of the remaining digit had occurred despite successful replantation in some cases. The healing indices of phalanges and metacarpals were analyzed.ResultsThe mean patient age was 42.8 years. The mean lengthening of the phalanges was 13.3 mm, while that of the metacarpals was 26.5 mm. The mean consolidation times were 144.4 days for the phalanges and 154.1 days for the metacarpals. The mean healing indices of the phalanges and metacarpals were 114 days/cm and 60 days/cm, respectively. No bone grafts were needed in any of the patients.ConclusionsDistraction lengthening of the digits after traumatic amputation is an effective procedure for hand reconstructive surgery for either the phalanges or the metacarpals and is less invasive than other techniques. The rate of healing of the metacarpals is two times faster than that of the phalanges.Copyright © 2020. Published by Elsevier Ltd.

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