Metatarsal Lengthening With Monolateral External Fixator Using Intramedullary Kirschner Wire in Brachymetatarsia Surgery

Brachymetatarsia is characterized by the parabola formed through the articulation of the metatarsophalangeal joints of the toes. It is defined as the termination of one or more metatarsals at least 5 mm proximal to this parabola, most commonly affecting the fourth metatarsal. Surgical interventions for brachymetatarsia include osteotomy followed by either acute distraction with grafting or gradual lengthening via distraction osteogenesis. In limb-lengthening procedures involving long bones of the lower extremity, an external fixator in conjunction with an intramedullary nail is commonly used. The combination of an elastic intramedullary nail with an external fixator allows for precise alignment while reducing the duration of external fixation. This technique underscores the significance of maintaining the correct vector an deplane of extension to ensure proper anatomical alignment of the metatarsal.