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ISSN 2007-087X (Print)
Órgano Oficial de la Sociedad Mexicana de Ortopedia Pediátrica

2018, Number 1

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Rev Mex Ortop Ped 2018; 20 (1)

Tibial lengthening in children using monolateral external fixator and submuscular plate

Pagano I, Noria A, von Heideken J, Pérez ME

Language: Spanish
References: 18
Page: 18-24
PDF size: 183.85 Kb.


ABSTRACT

Introduction: Limb lengthening can be performed through progressive distraction with external fixators, and to decrease the rate of complications, in combination with a submuscular plate. Objectives: To describe surgical characteristics of tibia lengthening with monolateral external fixator and submuscular plate in pediatric patients. Material and methods: A retrospective medical record review was performed on 14 consecutive patients (mean age = 12.7) (range 10-15; 40% female) operated between February 2008 and November 2012. Charts and radiographs were reviewed for demographics, surgical details, and complications related to the technique. Results: The average achieved lengthening was 4.9 cm (range 3.5-6.0). The average external fixator index was 14.7 days/cm (range, 11.5-19.4). The mean healing rate was 53 days/cm (range, 35.6-76). Eight patients (80%) faced complications, one of these patients had more than one complication including pseudoartrosis of the tibia. Patients returned to their normal activity level after an average of 249 days (range 174-324). Conclusions: This method of tibia lengthening seems to be as effective as the nail elongation method in relation to achieving the main goal of reducing the time of external fixation while being an option applicable in skeletally immature patients.


REFERENCES

  1. Ilizarov GA. The principles of the Ilizarov method. Bull Hosp Jt Dis Orthop Inst. 1988; 48(1): 1-11.

  2. Paley D, Herzenberg JE, Paremain G, Bhave A. Femoral lengthening over an intramedullary nail. A matched-case comparison with Ilizarov femoral lengthening. J Bone Joint Surg Am. 1997; 79(10): 1464-1480.

  3. Oh CW, Song HR, Kim JW, Choi JW, Min WK, Park BC. Limb lengthening with a submuscular locking plate. J Bone Joint Surg Br. 2009; 91(10): 1394-1399.

  4. Cha SM, Shin HD, Kim KC, Song JH. Plating after tibial lengthening: unilateral monoaxial external fixator and locking plate. J Pediatr Orthop B. 2013; 22(6): 571-576.

  5. Singh S, Lahiri A, Iqbal M. The results of limb lengthening by callus distraction using an extending intramedullary nail (Fitbone) in non-traumatic disorders. J Bone Joint Surg Br. 2006; 88(7): 938-942.

  6. Oh CW, Baek SG, Kim JW, Kim JW. Tibial lengthening with a submuscular plate in adolescents. J Orthop Sci. 2015; 20(1): 101-109.

  7. Iobst CA, Dahl MT. Limb lengthening with submuscular plate stabilization: a case series and description of the technique. J Pediatr Orthop. 2007; 27(5): 504-509.

  8. Tosun HB, Agir I, Gumustas S, Serbest S, Uludag A, Celik S. Tibial lengthening using a fixator-assisted lengthening plate: a new technique. Trauma Mon. 2016; 21(5): e25340.

  9. Georgiadis AG, Rossow JK, Laine JC, Iobst CA, Dahl MT. Plate-assisted lengthening of the femur and tibia in pediatric patients. J Pediatr Orthop. 2017; 37(7): 473-478.

  10. Moseley CF. A straight-line graph for leg-length discrepancies. J Bone Joint Surg Am. 1977; 59(2): 174-179.

  11. Dahl MT, Gulli B, Berg T. Complications of limb lengthening. A learning curve. Clin Orthop Relat Res. 1994; (301): 10-18.

  12. Kristiansen LP, Steen H, Reikerås O. No difference in tibial lengthening index by use of Taylor spatial frame or Ilizarov external fixator. Acta Orthop. 2006; 77(5): 772-777.

  13. Naudie D, Hamdy RC, Fassier F, Duhaime M. Complications of limb-lengthening in children who have an underlying bone disorder. J Bone Joint Surg Am. 1998; 80(1): 18-24.

  14. Paley D. Problems, obstacles, and complications of limb lengthening by the Ilizarov technique. Clin Orthop Relat Res. 1990; (250): 81-104.

  15. Lerner A, Chezar A, Haddad M, Kaufman H, Rozen N, Stein H. Complications encountered while using thin-wire-hybrid-external fixation modular frames for fracture fixation. A retrospective clinical analysis and possible support for “Damage Control Orthopaedic Surgery”. Injury. 2005; 36(5): 590-598.

  16. Danziger MB, Kumar A, DeWeese J. Fractures after femoral lengthening using the Ilizarov method. J Pediatr Orthop. 1995; 15(2): 220-223.

  17. Bost FC, Larsen LJ. Experiences with lengthening of the femur over n intramedullary rod. J Bone Joint Surg Am. 1956; 38-A(3): 567-584.

  18. Uysal M, Akpinar S, Cesur N, Hersekli MA, Tandoğan RN. Plating after lengthening (PAL): technical notes and preliminary clinical experiences. Arch Orthop Trauma Surg. 2007; 127(10): 889-893.




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