advertising
-
1
Schreck MA: Pediatric longitudinal epiphyseal bracket: review and case presentation. J Foot Ankle Surg 45: 342, 2006.
-
2
Glickman SH, Cornfield RH: Surgical reconstruction of a congenital foot deformity: hallux varus with brachymetatarsia of the first metatarsal. J Foot Surg 29: 499, 1990.
-
3
Neil MJ, Conacher C: Bilateral delta phalanx of the proximal phalanges of the great toes. A report on an affected family. J Bone Joint Surg Br 66: 77, 1984.
-
4
Sobel E, Levitz S, Cohen R, et al: Longitudinal epiphyseal bracket: associated foot deformities with implications for treatment. JAPMA 86: 147, 1996.
-
5
Watson HK, Boyes JH: Congenital angular deformity of the digits: delta phalanx. J Bone Joint Surg Am 49: 333, 1967.
-
6
Jones GB: Delta phalanx. J Bone Joint Surg Br 46: 226, 1964.
-
7
Theander G, Carstam N: Longitudinally bracketed diaphysis. Ann Radiol (Paris) 17: 355, 1974.
-
8
Light TR, Ogden JA: The longitudinal epiphyseal bracket: implications for surgical correction. J Pediatr Orthop 1: 299, 1981.
-
9
Pisani G: First Enclosed Metatarsal, Foot Surgery Treatise, 3rd ed, Minerva Medica, Italy, p 256, 2004.
-
10
Shea KG, Mubarak SJ, Alamin T: Preossified longitudinal epiphyseal bracket of the foot: treatment by partial bracket excision before. J Pediatr Orthop 21: 360, 2001.
-
11
Mubarak SJ, O’Brien TJ, Davids JR: Metatarsal epiphyseal bracket: treatment by central physiolysis. J Pediatr Orthop 13: 5, 1993.
-
12
Kucukkaya M, Kabukcuoglu Y, Tezer M, et al: Correcting and lengthening of metatarsal deformity with circular fixator by distraction osteotomy: a case of longitudinal epiphyseal bracket. Foot Ankle Int 23: 427, 2002.
Longitudinal Epiphyseal Bracket of the First Metatarsal: A Case Series on Treatment of Deformities Associated
Search for other papers by Marco Marcarelli in
Current site
Google Scholar
PubMed
Search for other papers by Carmelo Errichiello in
Current site
Google Scholar
PubMed
Search for other papers by Margherita Germano in
Current site
Google Scholar
PubMed
Search for other papers by Salvatore Risitano in
Current site
Google Scholar
PubMed
Search for other papers by Davide Deledda in
Current site
Google Scholar
PubMed
Search for other papers by Manfred Thomas in
Current site
Google Scholar
PubMed
Longitudinal epiphyseal bracket of the first metatarsal, also known as first enclosed metatarsal, is a rare congenital disorder characterized by an abnormal development in the length of the first metatarsal ray because of the asymmetric presence of a longitudinal epiphyseal bracket. This causes interruption in the lengthways development of the affected bone, which becomes squat and short, with a trapezoidal or triangular shape, leading to a hallux varus deformity. First enclosed metatarsal occurs in 2% to 14% of all congenital defects in the hands and feet; with bilateralism in 75% of cases and a greater incidence in male patients. The deformity is classified as a differentiation defect; it is frequently associated with abnormalities such as syndactyly or polydactyly. There are different surgical treatments reported in the literature. Most of them are aimed at the excision of the epiphyseal bracket before complete skeletal maturity and frequently in the first year of life to promote a normal lengthways growth of the bone. In this study, the authors present three cases of bilateral first enclosed metatarsal in which the surgical treatment, aimed at lengthening the first metatarsal ray by using the Penning Minifixator, was instead carried out at the end of growth. This different surgical approach allowed the planning of a surgical operation involving both the skeletal structures and the surrounding soft tissue.
advertising
