Metacarpal synostosis: a simple classification and a new treatment technique

Plastic and Reconstructive Surgery
G FoucherR K Khouri

Abstract

The current classification of metacarpal synostosis is based on the extent of the synostosis. The authors propose a new classification that takes into account the shape of the metacarpal bones, the curvature of the epiphysis, and the discrepancy in length between the two bones. This classification provides better guidelines for the correction of all components of the deformity. The classification is based on the authors' observations of and experience with 36 cases of metacarpal synostosis; 13 of the deformities were surgically corrected. The I-shaped deformity, whether with distinct (type d) or fused (type f) metacarpophalangeal joints, does not require surgical correction. The U-shaped deformity has parallel epiphysis and does not require surgery unless the two metacarpals are asymmetrical in length (type a) or tightly fused (type t); in these cases, simple lengthening or widening of the space with a bone graft is sufficient. Y-shaped synostosis should be separated whether the branches are symmetrical or asymmetrical, the latter having one branch shorter than the other. Because the epiphyses are already divergent, simple separation does not effectively correct Y-shaped synostosis. The authors propose an osteotomy to isolate a...Continue Reading

References

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Citations

Jan 31, 2006·The Journal of Hand Surgery : Journal of the British Society for Surgery of the Hand·Guy FoucherJose Medina
Feb 16, 2012·European Journal of Human Genetics : EJHG·Sajid Malik
Sep 11, 2012·The Journal of Hand Surgery·Hilton P GottschalkTerry R Light
Feb 15, 2017·The Journal of Hand Surgery, European Volume·S Farr, W Girsch
Oct 5, 2016·Hand : Official Journal of the American Association for Hand Surgery·Michael B GottschalkHilton P Gottschalk
Jan 22, 2004·American Journal of Medical Genetics. Part a·Fortunato LonardoGioacchino Scarano

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