A modified surgical technique for lengthening of a metatarsal using an external fixator.

Brachymetatarsia is a congenital or developmental condition that results in a short metatarsal. Problems that arise from this condition can include pain, difficulty with shoe wear, and cosmetic concerns. Multiple techniques have been described that successfully correct the deformity, including both acute and gradual distraction.

Humeral lengthening and deformity correction with the multiaxial correction system.

Unlabelled: Limb lengthening for humeral length discrepancy is typically accomplished using a traditional monolateral external fixator frame or an Ilizarov-type device, which have distinct shortcomings for the correction of concomitant deformity and application to the upper extremity, respectively. A new monolateral frame, the multiaxial correction (MAC) system, provides advantage over other monolateral frames and Ilizarov-type devices for humeral lengthening and may achieve similar outcomes. The purpose of this study was to report on the use of the MAC system for limb lengthening in pediatric patients, each with humeral length discrepancy and deformity.

Juvenile dermatomyositis with bilateral progressive knee flexion contracture.

Juvenile dermatomyositis is a multisystem, inflammatory vasculopathy that primarily affects muscles and skin. Calcinosis is one of the most debilitating complications affecting patients with juvenile dermatomyositis. Calcifications resulting from calcinosis frequently are located on the elbows, knees, and other joints and can cause considerable disability with severe pain, joint contractures, skin ulcers, and muscle atrophy.

Traumatic segmental bone loss in a pediatric patient treated with bifocal bone transport.

Bone transport is a method of distraction osteogenesis that allows the creation of regenerate bone using a dynamic external fixator. We report on the use of bifocal bone transport to treat a skeletally immature patient with 15 cm of post-traumatic segmental bone loss from the distal tibia.

Lengthening of a free fibular graft after sarcoma resection of the humerus.

We report a patient who had resection of the humerus for osteosarcoma, initial reconstruction with a free fibular graft of the humerus, and subsequent lengthening of the graft. A 9-cm (100% of free fibula length) lengthening was achieved to equalize the humerus length. A complication of regenerate fracture was treated successfully with plating.