Objective: To investigate the application and effectiveness of metatarsal mortise and tenon shortening osteotomy in the treatment of macrodactyly in children.
Methods: The clinical data of 17 children with macrodactyly (18 feet and 27 toes) admitted between January 2018 and January 2020 were retrospectively analyzed. There were 12 males (12 feet and 18 toes) and 5 females (6 feet and 9 toes); the age ranged from 1 to 13 years, with a median age of 5 years. All children were treated with metatarsal mortise and tenon shortening osteotomy. Ten cases of single-segment metatarsals were shortened, 7 cases of 2-segment metatarsals, and 1 case of 3-segment metatarsals; involved 1 foot of single toe, 9 feet of 2 toes, 3 feet of 3 toes, 3 feet of 4 toes, and 2 feet of 5 toes. Five cases had lameness, and 1 case had limited walking with the big toes of both feet, and there was no obvious pain in all children. X-ray films showed that the involved phalanges were thickened and increased in 18 feet, and the deformity of the distal segment was heavier than that of the proximal segment in 13 feet, and the two were similar in 5 feet. The length of metatarsal shortening was 0.7-2.5 cm, with an average of 1.2 cm. The clinical healing of shortened metatarsal fractures in children was observed after operation, and the occurrence of related complications was recorded.
Results: All 17 children were followed up 6-22 months, with an average of 14 months. All incisions healed by first intention. The osteotomy ends of 27 toes were clinically healed after operation, and the healing time was 4-8 weeks. No nonunion, fracture displacement, malunion, epiphyseal plate premature closure, and needle tract infection occurred.
Conclusion: Metatarsal mortise and tenon shortening osteotomy is a good osteotomy method. It can improve the stability of the osteotomy end and increase the contact surface of the osteotomy end, which is conducive to the healing of the osteotomy end and is suitable for the treatment of macrodactyly.
目的: 探讨跖骨榫卯形截骨短缩术在儿童巨趾畸形治疗中的应用及疗效。.
方法: 回顾性分析2018年1月—2020年1月收治的17例（18足27趾）巨趾患儿临床资料。其中男12例（12足18趾），女5例（6足9趾）；年龄1～13岁，中位年龄5岁。累及单列趾1足，2列趾9足，3列趾3足，4列趾3足，5列趾2足。术前5例出现跛行，1例双足巨趾行走受限，均无明显疼痛。X线片示受累趾骨增粗、增长18足；远节畸形较近节严重13足，二者相近5足。均采用跖骨榫卯形截骨短缩术矫正巨趾。短缩单节跖骨10例，2节跖骨7例，3节跖骨1例。跖骨短缩长度0.7～2.5 cm，平均1.2 cm。术后观察患儿短缩跖骨骨折愈合情况，并记录相关并发症发生情况。.
结果: 术后17例患儿均获随访，随访时间6～22个月，平均14个月。切口均Ⅰ期愈合。术后27趾截骨端均获临床愈合，愈合时间4～8周。未发生骨不连、骨折移位及畸形愈合，无骺板早闭及针道感染发生。.
结论: 跖骨榫卯形截骨短缩术是一种良好的截骨方式，在短缩跖骨的同时提高截骨端稳定性，增大截骨端接触面，利于截骨端愈合，适用于巨趾截骨短缩治疗。.
Keywords: Macrodactyly; children; metatarsal shortening; mortise and tenon osteotomy.