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One stage femoral lengthening
Clinical Orthopaedics and Related Research
|October 1, 1978
Summary
Femoral lengthening using Z osteotomy and distraction devices can achieve significant limb length gains. Careful adherence to technique minimizes complications, though non-union is a risk in older patients.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Limb reconstruction
Background:
- Limb length discrepancy is a common orthopedic issue.
- Femoral lengthening offers a solution for moderate discrepancies.
- Surgical techniques aim to maximize length gain while minimizing complications.
Purpose of the Study:
- To evaluate the efficacy and safety of a specific femoral lengthening technique.
- To identify factors influencing bone union and complications.
- To define optimal indications for the procedure.
Main Methods:
- A Z osteotomy and external distraction device were employed for femoral lengthening.
- Sustained knee flexion was used to prevent neurovascular complications.
- Decortication and internal fixation were utilized in older patients to promote bone union.
Main Results:
- Expected length gain: 3-3.5 cm in children, 4-4.5 cm in adults.
- Complications included 3 nerve palsies in 180 cases, attributed to technical non-compliance.
- Pseudarthrosis (non-union) occurred in 12 patients, primarily those over 16 years old, linked to avascular necrosis.
Conclusions:
- Femoral lengthening with Z osteotomy is effective for moderate limb length discrepancies.
- Adherence to surgical technique is crucial for preventing complications.
- Avascular necrosis poses a risk for non-union in skeletally mature patients, necessitating enhanced fixation methods.