Clinical Examples: Finger distraction lengthening with palatal expansion clamp and intercalated bone graft

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

 
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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.
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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).

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Construction of the fixator:

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Initial position:

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After two weeks of distraction:

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Bone grafting:

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Final result:

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Case 2. Middle phalanx lengthening with proximal metaphyseal osteotomy, distraction and bone graft:

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Finger distraction lengthening

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