Brachymetacarpia – our experience with internal device for distraction osteogenesis in adolescent patients

BACKGROUND: Brachymetacarpia is a rare deformity characterized by shortening of one or more metacarpals, most commonly the fourth. This study aimed to evaluate the outcomes of surgical treatment for brachymetacarpia using an internal mini distractor and to compare its advantages over external fixators and other surgical techniques. MATERIALS AND METHODS: We retrospectively analyzed 9 patients treated between 2011 and 2021 using gradual distraction osteogenesis with an internal mini distractor. Evaluated parameters included pre- and postoperative metacarpal lengths, deviation from ideal length, complications, treatment duration, and patient satisfaction. RESULTS: The mean lengthening was 1.2 cm (range 0.7-1.5 cm), with minimal deviation from the ideal metacarpal length (+0.3 cm on average). The average distraction period was 68 days. Minor complications occurred in 3 patients, including synovitis and delayed consolidation, all managed successfully. Functional outcomes and patient satisfaction were uniformly excellent. CONCLUSION: The internal distraction system provides a reliable, safe, and patient-friendly method for metacarpal lengthening. Compared to external fixators, it offers superior stability, reduced the risk of infection, and improved aesthetic and functional outcomes in selected cases.