S-osteotomy with lengthening and then nailing compared with traditional Ilizarov method
ABSTRACT The purpose of this study was to explore the clinical effect of the novel method combined longitudinal S-osteotomy and Lengthen And Then Nail (LATN) technique for leg lengthening and compare with the classic Ilizarov method.
This retrospective study was performed from March 2008 to April 2012. A total of 176 leg lengthenings (88 consecutive patients) were performed at our institution. The mean duration of follow-up was 2.2 years (range, one to four years). In group A, 78 tibial lengthenings were performed with longitudinal S-osteotomy and LATN technique. In group B, 98 tibial lengthenings were performed with the classic method. The final gain in length, mean surgical time for bilateral tibial osteotomy, the external fixation index and the radiographic consolidation index were calculated and compared. The complications encountered during operation and follow-up were documented.
There was no significant difference in the final gain in length between the two groups. Mean surgical time in group A (130.05 ± 6.60 min) was significantly longer than that in group B (91.4 ± 6.61 min; P < 0.05). External fixation index in group A (21.02 ± 3.16 days/cm) was significantly lower than that in group B (76.19 ± 8.32 days/cm; P < 0.05). Consolidation index was significantly lower (more rapid healing) in group A (43.38 ± 5.35 days/cm) than that in group B (76.19 ± 8.32 days/cm; P < 0.05). There was a significant difference in pin-tract problems and axial deviation between the two groups.
The novel method combined longitudinal S-corticotomy and LATN technique safely reduces the consolidation time, rate of pin-tract problems and axial deviation during leg lengthening, compared with the classic Ilizarov method.
- International Orthopaedics 12/2013; 38(3). DOI:10.1007/s00264-013-2236-3 · 2.02 Impact Factor
- International Orthopaedics 12/2013; 38(3). DOI:10.1007/s00264-013-2239-0 · 2.02 Impact Factor
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ABSTRACT: This study aimed to evaluate development of the tibia after Ilizarov lengthening and deformity correction depending on whether or not the simultaneous resection of fibular anlage was performed in children with fibular aplasia type II, who did not undergo early surgery. The study analyses results of reconstructive treatment in 38 children at the age of over four years. Two groups of children are compared: bifocal tibial lengthening with the Ilizarov device (group I) and bifocal lengthening associated with resection of the fibular anlage (group II). The results were estimated at 12 months and in the long-term exceeding three years. Radiological data of measurement of the anatomical lateral distal tibial angle (aLDTA) show surgical correction of deformities achieved in both groups. During the further limb growth a tendency to normalisation of the aLDTA was observed only in the group II. Quick relapse of the angular deformities of the tibial shaft in the first group occurred mainly during further growth of the limb regardless of complete correction at the time of treatment. On the other hand, there were no recurrences of diaphyseal deformities in the group II. In children with congenital fibular deficiency of type II at the age of four years, the bone lengthening and deformity correction should be associated with fibular anlage resection. That approach improves conditions for distal tibia development and prevents or decreases significantly the recurrence of deformities of the tibia and ankle joint in long-term follow-up.International Orthopaedics 04/2015; DOI:10.1007/s00264-015-2752-4 · 2.02 Impact Factor