Gradual Metatarsal Lengthening by External Fixation: A New Classification of Complications and a Stable Technique to Minimize Severe Complications

Foot & Ankle International
Dominique BarbierDimitry Popkov


The surgical management of brachymetatarsia remains controversial, and choice is based on potential complications. We report a classification of complications based on severity, and we hypothesized that use of a semicircular external fixator would minimize severe complications in lateral metatarsal lengthening. We retrospectively reviewed 30 patients (10 to 46 years old) with single or multiple brachymetatarsia and performed 54 metatarsal lengthenings with a mean follow-up of 7 months. The mean gain in length was 15 mm (33.7%), and the mean healing index was 67 d/cm. No further procedure was performed. No dislocations or subluxations were reported, but 26 complications (48.1%) occurred, classified as 1 severe (1.8% of the metatarsals), 5 intermediate (9.3%), and 20 benign (37%): 4 incomplete osteotomies, 8 adjacent metatarsal osteotomies, 2 involuntary adjacent metatarsal fixations due to the lack of fluoroscopy use, 6 early consolidations, 2 metatarsal fractures, 2 skin complications, 1 superficial infection, and 1 metatarsophalangeal clinodactyly. A classification of complications based on severity was developed. Gradual lengthening of the lateral metatarsals by semicircular external fixation reduced the risk of severe compli...Continue Reading


Mar 1, 1990·The Journal of Bone and Joint Surgery. British Volume·J HughesL Klenerman
Jul 1, 1986·Journal of the American Podiatric Medical Association·R B HandelmanW B Coleman
Jul 1, 1987·British Journal of Plastic Surgery·K Hosokawa, T Susuki
Apr 1, 1983·Journal of the American Podiatry Association·K K MahD W Falknor
Mar 1, 1995·The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons·S A AlterR G Rosen
Feb 1, 1994·Annals of Plastic Surgery·T KawashimaK Harii
Dec 11, 1997·The Journal of Bone and Joint Surgery. British Volume·Y TakakuraS Tamai
Nov 3, 1998·The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons·I M Fox
Dec 16, 1998·The Journal of Bone and Joint Surgery. British Volume·G H Baek, M S Chung
May 27, 1999·Journal of Pediatric Orthopedics·K MasadaH Ohno
Jun 27, 2003·Journal of Pediatric Orthopedics·Chang-Wug OhByung-Chul Park
Aug 2, 2003·The Journal of Bone and Joint Surgery. British Volume·H T KimJ T Suh
Oct 4, 2003·Foot & Ankle International·Hae-Ryong SongPoong-Taek Kim
Apr 15, 2004·Journal of Pediatric Orthopedics. Part B·Akifusa WadaTomoyuki Nakamura
Sep 28, 2004·The Journal of Bone and Joint Surgery. British Volume·J S KimP W Yoon
Mar 25, 2006·Journal of Pediatric Orthopedics·Jong Sup Shim, Seung Jun Park
Oct 3, 2009·Foot & Ankle International·Woo-Chun LeeJi Yeong Kim
Nov 3, 2009·The Journal of Bone and Joint Surgery. British Volume·W-C LeeJ-S Moon
Jan 9, 2010·Clinical Orthopaedics and Related Research·Sandro GianniniDeianira Luciani
Nov 19, 2010·The Journal of Bone and Joint Surgery. American Volume·Keun-Bae LeeJong-Keun Seon
Sep 18, 2012·Orthopaedics & Traumatology, Surgery & Research : OTSR·P LascombesP Journeau

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