Distraction epiphysiolysis in the treatment of uneven limb length

Background. In view of difference of opinion regarding the clinical value of limb lengthening by epiphyseal distraction we decided to analyze our own experiences in this area. Material and methods. Our research involved 31 children, 18 girls and 13 boys ranging in age from 7 to 14 years, treated by means of epiphyseal distraction in 17 femoral and 14 tibial segments. The mean initial shortening of the leg was 6 cm. During lengthening and after its conclusion we evaluated the extent of lengthening, the quality of the regenerated bone, and the status of the growth plate. The average follow-up was 6 years. Results. The mean limb lengthening was 5 cm (range 3-8), the average duration was 110 days, with a mean time to stabilization of 48 days (range 30-106). The mean lengthening index was 42 days/cm. Conclusions. In our opinion epiphyseal distraction is a simple procedure for limb lengthening, relatively non-invasive, but requiring considerable experience on the part of the clinical staff. The maximum lengthening should not exceed 6 cm. Monitoring of the lengthening process is very important in order to guarantee good quality regenerated bone. Epiphyseal distraction should be performed just before the child completes growth.