DISTRACTION-LENGTHENING OF D IG ITAL RAYS US ING A

We present 19 ray lengtbenings in 14 patients done with a small external fixator. In six eases the thumb was lengthened and in the other 13 eases, other digital rays. The most frequent reason for lengthening was an amputation sustained in a work accident. All the leogthenings were done by an osteotomy and subsequent gradual distraction with a small external fixator. The mean lengthening achieved was 20 mm (range, 0-32). An iliae-erest graft was needed in nine eases, corrective osteotomy in five eases and a deepening of the web in the six eases of thumb lengthening. In five eases an additional technique was needed to achieve bony consolidation. We have analysed the functional results and the ability to perform activities of daily living and resume employment. Although most of the patients had multiples injuries, the results have been very favourable, achieving a very high level of patient satisfaction. Journal of Hand Surgery (British and European Vohtme, 1998) 23B. " 6. " 781-784 Small external fixators have been developed for use in the hand. The main indications are for treatment of open or comminuted fractures, arthrodesis of a joint and metacarpal or phalangeal distraction-lengthening in congenital or traumatic amputations (Schuind et al, 1993). The method of lengthening the thumb by gradual distraction was first reported by Matev (1970). The method has been extended to the management of injured digits (Kessler et al, 1979; Ulitskyi and Malygin, 1973) and some congenital anomalies (Kessler et al, 1977). The purpose of this paper is to describe our experi-ence with distraction-lengthening six thumbs and 13 digital rays other than the thumb