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Limb lengthening by physeal distraction.

I Bjerkreim1

  • 1Oslo University Orthopedic Hospital, Sophies Minde, Norway.

Acta Orthopaedica Scandinavica
|April 1, 1989
PubMed
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Lengthening bone through the upper tibial physis (growth plate) in 9 patients resulted in frequent complications. This high risk of growth disturbance suggests physeal distraction is best reserved for the end of the growth period.

Area of Science:

  • Orthopedic surgery
  • Pediatric orthopedics
  • Limb lengthening surgery

Background:

  • Limb lengthening procedures are used to correct discrepancies in leg length.
  • Distraction osteogenesis is a common technique for limb lengthening.
  • The upper tibial physis is a potential site for surgical intervention.

Purpose of the Study:

  • To evaluate the outcomes of lengthening procedures performed through the upper tibial physis.
  • To assess the complication rates associated with this specific surgical approach.
  • To determine the safety and efficacy of physeal distraction in the upper tibia.

Main Methods:

  • A retrospective review of 10 consecutive tibial lengthenings in 9 patients.
  • Utilized bilateral Wagner devices with transfixing pins for distraction.

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  • Median lengthening achieved was 6.7 cm.

    • Main Results:

    • Complications were frequently observed in the cohort.
    • A high risk of growth disturbance was identified as a significant complication.
    • The study highlights the potential for adverse effects on physeal growth.

    Conclusions:

    • Lengthening through the upper tibial physis carries a substantial risk of growth disturbance.
    • Physeal distraction in this region should be approached with extreme caution.
    • Consideration should be given to performing such procedures only towards the end of the skeletal growth period.