title: Complications of distraction osteogenesis: a changing pattern.
abstract: We reviewed Mr. Simpson's first 80 consecutive limb-lengthening procedures, using either a circular or a unilateral frame, and analyzed the complication rates. The initially high complication rate (100%) decreased significantly (P < .01) with experience. Incidence of axial deviation was reduced by changing the configuration of the fixators; delayed consolidations and fractures were reduced by prophylactic bone-grafting and by minimizing the associated complication of muscle contractures; severe pin-track infection was reduced by introducing a simple protocol; and muscle contractures and joint subluxation were reduced by adjusting the bone screw insertion sites and ensuring adequate early analgesia to allow early movement.
authors.affiliation: Nuffield Department of Orthopaedic Surgery, Nuffield Orthopaedic Centre, Headington, Oxford, United Kingdom.
authors.forename: Harry C
authors.initials: HC
authors.lastname: Brownlow
authors.forename: A Hamish R W
authors.initials: AH
authors.lastname: Simpson
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D019857:Osteogenesis, Distraction / Q000009:adverse effects* / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D012720:Severity of Illness Index