Distraction osteogenesis for treatment of iatrogenic shortening of the first ray


  • Olga Drogomiretskiy, DPM, AACFAS Fellow, Virginia Mason Franciscan Health Sports Medicine Foot and Ankle Fellowship, Seattle, WA
  • Stephen Rockhill, DPM Resident, Franciscan Foot and Ankle Institute, Federal Way, WA
  • Tyler Reber, DPM, AACFAS Podiatric Surgeon, Northern Arizona Podiatry, Flagstaff, AZ
  • Byron Hutchinson, DPM, FACFAS Podiatric Surgeon and Fellowship Director, Franciscan Foot and Ankle Institute, Federal Way, WA
  • Craig Clifford, DPM, MHA, FACFAS, FACPM Podiatric Surgeon and Residency Director, Franciscan Foot and Ankle Institute, Federal Way, WA




callus distraction, deformity, external fixation, iatrogenic shortening first ray


The purpose of this study is to present a surgical treatment option following iatrogenic shortened first ray pathology and report the postoperative outcomes. Retrospective analysis of two surgeon’s patients (N=5) who underwent gradual distraction osteogenesis following previously failed first ray surgery was conducted.  Surgical outcomes were measured including time in the external fixator and amount of distraction achieved. Complications measured included neurovascular complications, non-union, mal-union, infections, mal-alignment, pain, wound dehiscence, stiffness and transfer metatarsalgia. The average time spent in an external fixator was 78.8 (34-108) days. Average distraction achieved was 12.2 (2-22) mm. Four of the 5 patients experienced at least one of the following postoperative complications: pin site infections, wound dehiscence, non-union and postoperative pain. This study suggests that distraction osteogenesis may be a feasible surgical treatment option for iatrogenic shortened first ray with the right patient selection, but needs further evaluation. 


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How to Cite

Drogomiretskiy O, Rockhill S, Reber T, Hutchinson B, Clifford C. Distraction osteogenesis for treatment of iatrogenic shortening of the first ray. J Int Foot Ankle [Internet]. 2022 Sep. 1 [cited 2023 Jun. 4];1(9). Available from: https://internationalfootankle.org/journal/index.php/JIFAF/article/view/32

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