자가 두개골 이식을 이용한 단중족골증의 치료 = A TREATMENT OF BRACHYMETATARSIA USING THE CRANIAL BONE GRAFT

다국어 초록 (Multilingual Abstract)

Brachymetatarsia frequently affects the fourth toe, and is more common in females, The etiology is obscure but the premature closure of epiphysis results in early union and cessation of metatarsal growth.
The abnormally short metatarsus is both clinically and radiographically evident with an associated shortened and contracted toe. The deformity is usually asymptomatic but produces a serious cosmetic and psychological problems.
For the corrction fo brachymetatarsia, many different surgical alternatives have been presented. We adopted the modified Jinnaka's method : interposing the autogeneous cranial bone graft within the metatarsophalangeal joint of the metatarsophalangeal joint for reducing the tension dorsally on the digit. Postoperatively the short leg splont was removed two weeks after the operation. During the next four weeks, the walking cast was applied and weight bearing was begun.
During recent 4 years, 9 brachymetatarsia developed in the 4th toe in 5 patients were treated with this technique and good postoperative results were achieved in cosmetic and functinal aspects.

This method has following merits.
1. The cranial bone is less absorbable than the rib or iliac crest.
2. The lengthening of the dorsal skin is easily obtained by means of Z-plasty over the dorsal skin of the metatarsophalangeal joint.
3. By interposing a bone graft within the metatarsophalangeal joint, bone lengthening of two centimenters or more could be achieved and the patients could walk without fracture of the grafted bone except one toe, in which pseudojoint is formed with normal gait.