Evaluating the Effectiveness of Distraction Lengthening in Traumatic Hand Amputations.

Abstract

Background: Fingers are highly susceptible to injuries, leading to functional impairment, particularly in the thumb and index finger. While traditional reconstructive methods exist, they often involve multiple surgeries and complications. Distraction lengthening, a minimally invasive technique, promotes bone and soft tissue regeneration, making it a promising alternative for digital lengthening. This study aims to assess the efficacy and functional results of distraction lengthening in patients with traumatic shortening of digits. Methods: This was a prospective observational cohort study conducted at a tertiary care centre. This study evaluated distraction histogenesis in 11 trauma patients with digital shortening. A unilateral mini external fixator was used for gradual distraction following osteotomy. Distraction began 5-7 days post-surgery at 1 mm/day, with healing monitored via radiographs. Functional recovery, length gained, healing index and patient satisfaction were assessed over a 1-year follow-up. Results: Patients (73% male, aged 16-30) primarily sustained machinery-related injuries. The mean preoperative shortness was 20.4 mm, with an average length gain of 20.2 mm. The mean external fixation and consolidation times were 111.3 and 91.36 days, respectively. The healing index averaged 47.5 days/cm. Functional grip, thumb web space and hand utility improved significantly, with success influenced by stable fixator use, surgical technique and patient adherence. Conclusions: Distraction lengthening is a reliable and effective method, offering functional restoration with minimal invasiveness. Despite prolonged treatment, it preserves sensitivity, prevents stiffness and eliminates the need for bone grafting. Level of Evidence: Level IV (Therapeutic).