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Correction of leg-length discrepancy after hip transposition
Robert Rödl1, Georg Gosheger, Benedikt Leidinger
1Department of Orthopaedics, University Hospital of Muenster, Germany. roedl@uni-muenster.de
Clinical Orthopaedics and Related Research
|December 4, 2003
Summary
Limb lengthening using distraction osteogenesis effectively corrected leg-length discrepancies in patients post-pelvic sarcoma surgery. This procedure offers functional improvement for long-term survivors, with complication rates comparable to general bone lengthening.
Area of Science:
- Orthopedic Surgery
- Pediatric Oncology
- Reconstructive Surgery
Background:
- Pelvic sarcomas often necessitate surgical resection, including hip transposition, which can lead to significant leg-length discrepancies.
- Developing a leg-length discrepancy after pelvic sarcoma treatment poses functional challenges for patients.
Purpose of the Study:
- To evaluate the efficacy of limb lengthening via distraction osteogenesis in correcting leg-length discrepancies after pelvic sarcoma resection and hip transposition.
- To assess functional outcomes and complication rates associated with this reconstructive procedure.
Main Methods:
- Retrospective analysis of four patients (three with Ewing's sarcoma, one with osteosarcoma) who underwent limb lengthening after pelvic sarcoma surgery and hip transposition.
- Patients received chemotherapy and, in some cases, radiotherapy. Femur lengthening was initiated years after initial tumor surgery.
Main Results:
- Achieved an average lengthening of 6.4 cm, correcting an average discrepancy of 10.3 cm.
- Reported an average healing index of 32 days per cm of elongation.
- Two minor complications and two problems required additional interventions. Final functional scores averaged 73% (Musculoskeletal Tumor Society scale).
Conclusions:
- Distraction osteogenesis is a viable method for correcting leg-length discrepancies following hip transposition after pelvic sarcoma resection.
- Limb lengthening should be considered for long-term survivors of pelvic sarcoma with at least 5 years of event-free survival, given the generally poor prognosis of these tumors.