Submuscular Plate Stabilisation After Lengthening: Standard and Modified Techniques.

Area of Science:

• Orthopedic surgery
• Biomechanical engineering

Background:

• Distraction osteogenesis of the femur often requires prolonged external fixation.
• Submuscular plating can potentially shorten this period.
• Femoral lengthening may necessitate angular correction, requiring specific plating techniques.

Purpose of the Study:

• To evaluate the safety and efficacy of submuscular plating after femur lengthening.
• To compare standard and modified plating techniques.
• To assess the duration of external fixation and associated complications.

Main Methods:

• Review of eight cases utilizing standard and modified submuscular plating techniques.
• Assessment of lengthening achieved, distraction period, and external fixator index.
• Evaluation of complications including joint stiffness, contractures, and infections.

Main Results:

• Mean lengthening was 5cm (range 3-9cm).
• External fixation index ranged from 18 to 58 days/cm.
• No joint subluxation, deep infection, re-fracture, or implant failures occurred. Minor complications like quadriceps contracture and transient knee stiffness were managed successfully.

Conclusions:

• Submuscular plating, both standard and modified, is a safe and effective method for femur lengthening.
• This technique significantly reduces the duration of external fixation.
• The modified technique facilitates easier plate insertion in cases with bone deformity.