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Botulinum toxin a does not decrease calf pain or improve ROM during limb lengthening: a randomized trial.

Dong Hoon Lee1, Keun Jung Ryu, Dong Eun Shin

  • 1Department of Orthopaedic Surgery, Severance Hospital, College of Medicine, Yonsei University, 134 Sinchondong, CPO Box 8044, Seoul, Republic of Korea, orthopaedee@naver.com.

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Summary

Botulinum Toxin Type A injections did not reduce calf pain or improve range of motion during tibial lengthening. Further research is needed to explore potential smaller effects in larger patient populations.

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Area of Science:

  • Orthopedics
  • Regenerative Medicine
  • Pain Management

Background:

  • Lower limb lengthening can cause significant muscle pain and joint contractures.
  • Effective treatments for these complications are limited.

Purpose of the Study:

  • To evaluate the efficacy of Botulinum Toxin Type A (BtX-A) injections in calf muscles during tibial lengthening.
  • To determine if BtX-A reduces calf pain and improves range of motion (ROM) by decreasing muscle stiffness.

Main Methods:

  • A double-blinded, randomized controlled trial involving 36 patients undergoing tibial lengthening.
  • BtX-A (200 IU) was injected into the calf muscle of one leg, with saline as a control in the other.
  • Pain (VAS score), knee/ankle ROM, and calf circumference were assessed post-injection.

Main Results:

  • No significant differences were observed in calf pain, knee and ankle ROM, or calf circumference between the BtX-A treated leg and the control leg.
  • The distraction rate and final length gain were similar in both groups.

Conclusions:

  • Local BtX-A injection (200 IU) in the calf muscle does not effectively reduce pain or enhance joint ROM during tibial lengthening.
  • The study was powered to detect large effects; larger trials are necessary to investigate potential smaller treatment benefits.