These are two cases of traumatically shortened fingers lengthened with paired palatal expansion clamps used to construct miniature progressive skeletal distraction followed by intercalary bone grafting |
Click on each image for a larger picture |
Case 1. This patient had an unstable small fingertip following a saw injury which resulted in loss of the central half of the distal phalanx of the small finger. |
A palatal expansion clamp with a turnbuckle mechanism was used to design a progressively lengthening external fixator to restore length of the distal phalanx before reconstruction with a bone graft, here shown on a plastic sawbone model. This device is available at http://www.greatlakesortho.com and other orthodontic supplier retailers (no commercial interest). |
Construction of the fixator: |
Initial position: |
After two weeks of distraction: |
Bone grafting: |
Final result: |
Case 2. Middle phalanx lengthening with proximal metaphyseal osteotomy, distraction and bone graft: |
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