Use of the distraction method in hand surgery.

The author describes three prototypes of a miniature distractor for the bones of hand constructed according to his own design, and its uses in clinical practice. The distractors are used for lengthening bones of the hand after injuries involving loss of the thumb or fingers, and for the treatment of patients with congenital developmental defects of the hand. Over a period of three years, the distractors were used in thirteen cases and Ilizarov's original apparatus in three cases: for the lengthening of metacarpus I in seven cases, metacarpus II in two cases, metacarpi II-IV in one case, metacarpi II-V also in one case. Similarly, in one case each for the elongation of the proximal and medial phalanges of fingers. A lengthening of 3.5 to 3.7 was achieved. Ilizarov's apparatus was exploited in two cases to lengthen the bone of the forearm for congenital hypoplasia of the radius and ulna, and for metatarsal bone lengthening in a case of congenital aplasia of the toes and hypoplasia of the remaining bones of the foot. In the last three cases a lengthening of 10 cm was achieved.