» Articles » PMID: 12678363

Acute Correction of Lower Limb Deformity and Simultaneous Lengthening with a Monolateral Fixator

Overview
Date 2003 Apr 8
PMID 12678363
Citations 20
Authors
Affiliations
Soon will be listed here.
Abstract

We have reviewed, retrospectively, all children with a lower limb deformity who underwent an acute correction and lengthening with a monolateral fixator between 1987 and 1996. The patients were all under the age of 19 years and had a minimum follow-up of eight months after removal of the fixator. A total of 41 children had 57 corrections and lengthening. Their mean age was 11.3 years (3.2 to 18.7) and there were 23 girls and 18 boys. The mean maximum correction in any one plane was 23 degrees (7 to 45). In 41 bony segments (either femur or tibia) a uniplanar correction was made while various combinations were carried out in 16. The site of the osteotomy was predominantly diaphyseal, at a mean of 47% (17% to 73%) of the total bone length and the mean length gained was 6.4 cm (1.0 to 17.0). Univariate analysis identified a moderately strong relationship between the bone healing index (BHI), length gained, maximum correction and grade-II to grade-III complications. For logistic regression analysis the patients were binary coded into two groups; those with a good outcome (BHI < or = 45 days/cm) and those with a poor outcome (BHI > 45 days/cm). Various factors which may influence the outcome were then analysed by calculating odds ratios with 95% confidence intervals. This analysis suggested a dose response between increasing angular correction and poor BHI which only reached statistical significance for corrections of larger magnitude. Longer lengthenings were associated with a better BHI while age and the actual bone lengthened had little effect. Those patients with a maximum angulatory correction of less than 30 degrees in any one plane had an acceptable consolidation time with few major complications. The technique is suitable for femoral deformity and shortening, but should be used with care in the tibia since the risk of a compartment syndrome or neurapraxia is much greater.

Citing Articles

Results of Lower Limb Bone Lengthening by Using Motorized and Magnet-Driven Intramedullary Nails to Treat Limb Length Discrepancy.

Al-Sayyad M, Alshoaibi F, Alshuaibi A, Almohammadi A, Almaghrabi H, Alsaady A Cureus. 2025; 17(1):e77212.

PMID: 39925552 PMC: 11807256. DOI: 10.7759/cureus.77212.


Antegrade femoral lengthening and simultaneous hemiepiphysiodesis for congenital femoral deficiency.

Georgiadis A, Albright P, Huser A, Novotny S, Dahl M J Child Orthop. 2024; 18(2):200-207.

PMID: 38567040 PMC: 10984157. DOI: 10.1177/18632521241229619.


Lengthening Patients Previously Treated for Massive Lower Limb Reconstruction for Bone Tumors with the PRECICE 2 Nail.

Campanacci L, Cevolani L, Focaccia M, Di Gennaro G, Dozza B, Staals E Children (Basel). 2023; 10(11).

PMID: 38002863 PMC: 10670507. DOI: 10.3390/children10111772.


Is the High Healing Index a Complication of Progressive Long Bone Lengthening? Observations from a Cohort of 178 Children Treated with Circular External Fixation for Lower Limb Length Discrepancy.

Depaoli A, Magnani M, Casamenti A, Cerasoli T, Ramella M, Menozzi G Children (Basel). 2023; 10(10).

PMID: 37892249 PMC: 10605005. DOI: 10.3390/children10101586.


[Options and limits of leg length correction in paediatric orthopaedics].

Vogt B, Rolfing J, Rodl R, Tretow H Orthopadie (Heidelb). 2023; 52(9):719-728.

PMID: 37561147 DOI: 10.1007/s00132-023-04420-3.