Treatment of congenital leg length discrepancies in children using an Ilizarov external fixator: a comparative study

Area of Science:

• Orthopedic surgery
• Pediatric orthopedics
• Biomechanical engineering

Background:

• Congenital leg length discrepancies (LLD) present significant challenges in pediatric orthopedic care.
• Traditional Ilizarov external fixation is a common treatment but can be associated with prolonged treatment times and variable outcomes.
• Optimizing limb lengthening techniques is crucial for improving patient function and reducing morbidity.

Purpose of the Study:

• To evaluate the impact of intramedullary (IM) alignment combined with Ilizarov external fixation on the healing index (HI) and lengthening index (LI) in treating congenital LLD.
• To compare the efficacy of the conventional Ilizarov technique versus a combined Ilizarov and IM alignment approach.

Main Methods:

• A comparative study involving 35 pediatric patients (ages 3.5-19) with congenital LLD.
• Group I: Limb lengthening using Ilizarov external fixator alone.
• Group II: Limb lengthening using Ilizarov external fixator combined with IM alignment via two Kirschner wires.

Main Results:

• Significant differences were observed in the duration of external fixator application and the healing index (HI) between the two groups.
• The combined Ilizarov and IM alignment group demonstrated a reduced external fixator duration and an improved HI.
• Patients treated with the combined method showed better overall outcomes for congenital LLD.

Conclusions:

• The combination of intramedullary alignment with Ilizarov external fixation offers significant advantages in treating congenital leg length discrepancies.
• This integrated approach leads to a shorter external fixator application period and a more favorable healing index.
• Intramedullary alignment is a beneficial adjunct to Ilizarov fixation for optimizing limb lengthening outcomes in pediatric patients.