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Limb lengthening in children using the Ilizarov method
C Bonnard1, L Favard, I Sollogoub
1Pediatric Hospital, Orthopedic Unit, Tours, France.
Insights
The Ilizarov method achieved limb lengthening in children, with an average of 50mm. While effective, complications like joint stiffness and modified limb axes occurred in over half the patients.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Regenerative medicine
Background:
- Limb lengthening is a reconstructive surgical procedure used to correct limb length discrepancies.
- The Ilizarov method is a widely used technique for limb lengthening and deformity correction.
- Assessing the efficacy and complication rates of the Ilizarov method in pediatric patients is crucial for surgical decision-making.
Purpose of the Study:
- To evaluate the outcomes of limb lengthening using the Ilizarov method in a pediatric cohort.
- To analyze the complication rates associated with the Ilizarov technique in children.
- To compare the Ilizarov method with alternative techniques like the Wagner technique and open corticotomy.
Main Methods:
- A cohort of 24 children underwent limb lengthening using the Ilizarov method, with an average age of 11 years.
- Limb lengthening averaged 50 mm over approximately 50 days.
- Outcomes were assessed using the healing index (average 35 days/cm) and corticotomy index, with complication rates meticulously recorded.
Main Results:
- The average limb lengthening achieved was 50 mm, with an average healing index of 35 days per centimeter.
- Complications were observed in 13 of 26 patients, including joint stiffness (8 cases), modified biomechanical axes (5 cases), and wire-tract infections (3 cases).
- The Ilizarov method demonstrated a lower complication rate compared to the Wagner technique, and open corticotomy showed potential for fewer complications.
Conclusions:
- The Ilizarov method is a viable option for pediatric limb lengthening, achieving significant length gains.
- Despite its effectiveness, the Ilizarov method is associated with a notable rate of complications, necessitating careful patient selection and management.
- Alternative techniques, such as modified open corticotomy, may offer a reduced complication profile for limb lengthening procedures in children.
Abstract:
By limb lengthening with the Ilizarov method on 24 children with an average age of 11 years, the average lengthening was 50 mm. The results were judged by the healing index and the corticotomy index. The average time for lengthening was 50 days. The healing index was on average 35 days per centimeter. Five complications were noticed during the first stage of the surgical procedure. During the lengthenings, eight cases of joint stiffness were observed, and in five normal biomechanical axes of the limb were modified. Only one abnormal biomechanical axis was perfectly corrected of eight present before surgery. There were three wire-tract infections. Only 13 of 26 patients were without any complications. The Ilizarov method had a lower rate of complication than the Wagner technique, however. Open corticotomy, as modified by De Bastiani, may accomplish lengthenings with somewhat fewer complications.