{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:58:59Z","timestamp":1787032739573,"version":"build-2736575974"},"reference-count":14,"publisher":"MDPI AG","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2007,5,1]]},"abstract":"Background: Congenital brachymetatarsia is often treated with callus distraction. This technique is associated with a variety of complications. We investigated complications encountered in treatment of brachymetatarsia in four female patients and reviewed adjunctive procedures performed to treat these complications.<\/jats:p>\n Methods: We reviewed five distraction osteogenesis procedures performed in four female patients with congenital shortening of the fourth metatarsal over a 3-year period. Serial radiographs were obtained weekly until bone consolidation was achieved, at which time the external fixator was removed. Follow-up ranged from 5 to 10 months.<\/jats:p>\n Results: Three patients (four metatarsals) were satisfied with the cosmetic and functional outcomes of their procedure. One patient was dissatisfied with the cosmetic result owing to a short digit from a short proximal phalanx but was completely functional and resumed all of her normal activities. Complications associated with callus distraction were decreased range of motion and stiffness at the metatarsophalangeal joint, flexion deformity of the digit, angulation of the metatarsal, prolonged distraction time due to pain, fracture of the bone callus, pin-site infection, and an undesirable cosmetic appearance due to a short proximal phalanx. Adjunctive procedures were needed in some of these cases and yielded good results.<\/jats:p>\n Conclusions: Callus distraction is an effective treatment for congenital shortening of the fourth metatarsal, but the procedure is associated with a number of complications. Because most patients proceed with surgery for cosmetic reasons, it is important to present the possible complications and the adjunctive surgical procedures that may be necessary for a desirable outcome. (J Am Podiatr Med Assoc 97(3): 189\u2013194, 2007)<\/jats:p>","DOI":"10.7547\/0970189","type":"journal-article","created":{"date-parts":[[2014,4,1]],"date-time":"2014-04-01T10:07:52Z","timestamp":1396346872000},"page":"189-194","source":"Crossref","is-referenced-by-count":19,"title":["Complications Associated with Distraction Osteogenesis for the Correction of Brachymetatarsia"],"prefix":"10.3390","volume":"97","author":[{"given":"Peter M.","family":"Wilusz","sequence":"first","affiliation":[{"name":"Department of Surgery, Southeast Michigan Surgical Hospital, Warren, MI."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phi","family":"Van","sequence":"first","affiliation":[{"name":"Department of Podiatry, Siena Medical Clinic, Garden City, KS."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy R.","family":"Pupp","sequence":"first","affiliation":[{"name":"Department of Surgery, Kern Hospital Clinic, Warren, MI."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"2020060319271395400_R1","doi-asserted-by":"crossref","unstructured":"Choi HI, Chung MS, Baek GH, et al: Metatarsal lengthening in congenital brachymetatarsia: one stage lengthening versus lengthening by callotasis. .J Pediatr Orthop19::660. ,1999. .","DOI":"10.1097\/01241398-199909000-00021"},{"key":"2020060319271395400_R2","doi-asserted-by":"crossref","unstructured":"Fox IM: Treatment of brachymetatarsia by the callus distraction method. .J Foot Ankle Surg37::391. ,1998. .","DOI":"10.1016\/S1067-2516(98)80047-1"},{"key":"2020060319271395400_R3","doi-asserted-by":"crossref","unstructured":"Oh CW, Sharma R, Song HR, et al: Complications of distraction osteogenesis in short fourth metatarsals. .J Pediatr Orthop23::484. ,2003. .","DOI":"10.1097\/01241398-200307000-00013"},{"key":"2020060319271395400_R4","doi-asserted-by":"crossref","unstructured":"Masada K, Fujita S, Fuji T, et al: Complications following metatarsal lengthening by callus distraction for brachymetatarsia. .J Pediatr Orthop19::394. ,1999. .","DOI":"10.1097\/01241398-199905000-00021"},{"key":"2020060319271395400_R5","doi-asserted-by":"crossref","unstructured":"Mahan K: Bone graft reconstruction of a flail digit. .JAPMA82::264. ,1992. .","DOI":"10.7547\/87507315-82-5-264"},{"key":"2020060319271395400_R6","doi-asserted-by":"crossref","unstructured":"Skirving AP, Newman JH: Elongation of the first metatarsal. .J Pediatr Orthop3::508. ,1983. .","DOI":"10.1097\/01241398-198309000-00018"},{"key":"2020060319271395400_R7","doi-asserted-by":"crossref","unstructured":"Takakura Y, Tanaka Y, Fuju T, et al: Lengthening of short great toes by callus distraction. .J Bone Joint Surg Br79::955. ,1997. .","DOI":"10.1302\/0301-620X.79B6.0790955"},{"key":"2020060319271395400_R8","doi-asserted-by":"crossref","unstructured":"Wakisaku T, Yasui N, Kujimoto H, et al: A case of short metatarsal bones lengthened by callus distraction. .Act Orthop Scand59::194. ,1988. .","DOI":"10.3109\/17453678809169708"},{"key":"2020060319271395400_R9","doi-asserted-by":"crossref","unstructured":"Levine SE, Davidson RS, Dorman JP, et al: Distraction osteogenesis for congenitally short lesser metatarsals. .Foot Ankle Int16::196. ,1995. .","DOI":"10.1177\/107110079501600405"},{"key":"2020060319271395400_R10","doi-asserted-by":"crossref","unstructured":"Ilizarov GA: Clinical application of the tension-stress effect for limb lengthening. .Clin Orthop250::81. ,1990. .","DOI":"10.1097\/00003086-199001000-00003"},{"key":"2020060319271395400_R11","doi-asserted-by":"crossref","unstructured":"Magnan B, Bragantini A, Regis D, et al: Metatarsal lengthening by callotasis during the growth phase. .J Bone Joint Surg Br77::602. ,1995. .","DOI":"10.1302\/0301-620X.77B4.7615606"},{"key":"2020060319271395400_R12","doi-asserted-by":"crossref","unstructured":"Boike A, Gerber M, Snyder A: Brachymetatarsia: axial lengthening by using callus distraction technique. .JAPMA83::373. ,1993. .","DOI":"10.7547\/87507315-83-7-373"},{"key":"2020060319271395400_R13","doi-asserted-by":"crossref","unstructured":"Martin D, Stran D, Southerland J, et al: Callus distraction in reconstructive foot surgery. .J Foot Ankle Surg35::489. ,1996. .","DOI":"10.1016\/S1067-2516(96)80070-6"},{"key":"2020060319271395400_R14","doi-asserted-by":"crossref","unstructured":"Ilizarov G: The tension-stress effect on the genesis and growth of tissues: part II. 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