title: Attempted limb lengthenings beyond twenty percent of the initial bone length: results and complications.
abstract: In response to historic guidelines suggesting limits to the amount of limb lengthening, we report the results and complications of those patients in whom the initial goal of lengthening exceeded 20% of the initial segment length. Thirty-one patients underwent a total of 35 attempted lengthenings with a mean follow-up of 38.6 months. Limb-length discrepancy was the primary indication in all but one case. With an average goal of 35% of the original bone length, we achieved a mean gain of 33%. Lengthening to within 2.5 cm was achieved in 31 (89%) of 35 cases, and significantly more successful with goals extending < or =55% of the initial bone length (p<0.05). Treatment times extended a mean of 8.7 months with a healing index of 37 days/cm. By Paley's classification scheme, all had problems, in addition to an average of 1.3 obstacles and 0.9 complications per segment lengthened. In 23 patients with extended follow-up, good to excellent results were achieved in 78%, and were significantly more successful with goals < or =55% (< or =0.05).
authors.affiliation: Shriners Hospital for Children, Honolulu, Hawaii 96826, USA.
authors.forename: A G
authors.initials: AG
authors.lastname: Yun
authors.forename: R
authors.initials: R
authors.lastname: Severino
authors.forename: K
authors.initials: K
authors.lastname: Reinker
mesh_terms: D001132:Arm / Q000254:growth & development / Q000601:surgery; D001852:Bone Lengthening / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018889:Ilizarov Technique / Q000009:adverse effects* / Q000592:standards; D007866:Leg / Q000254:growth & development / Q000601:surgery; D007870:Leg Length Inequality / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications; D011859:Radiography; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016896:Treatment Outcome