Comparison of the complication rates between first and second (repeated) lengthening in the same limb segment

The purpose of this study is to compare the incidence and types of complications in children who are undergoing first and second (repeated) lengthenings of the same bone. This is a retrospective review of 11 children (12 limbs) who underwent limb lengthenings of the same bone twice. There were 7 femoral and 5 tibial repeated lengthenings. Diagnoses included congenital femoral deficiency or proximal femoral focal deficiency in 6 patients, fibular hemimelia in 2, achondroplasia in 2, and tibial hypoplasia in 1. Mean age was 8.5 years for the first lengthening and 11.5 years for the second lengthening. There were 2.2 complications per lengthening for the first procedure and 1.5 for the second lengthening. There were 5 major and 22 minor complications for the first lengthening and 1 major and 17 minor complications for the second lengthening, none of these data were found to be statistically different. The healing index was 1.3 +/- 0.43 months per cm first lengthening and 2.2 +/- 1.7 cm for the second lengthening. This study did not demonstrate a significantly higher rate of complications with repeated lengthening of the same limb, although the time in the fixator for the second lengthening was longer and the degree of lengthening less.