title: Reduced lengthening index by use of bifocal osteotomy in the tibia: comparison of monofocal and bifocal procedures with the Ilizarov external fixator.
abstract: We lengthened 63 tibial segments in 49 patients, performing a monofocal osteotomy on 31 segments and a bifocal osteotomy on 32 segments. In the monofocal osteotomy group, the average lengthening was 4.8 (2.4-7.1) cm with a lengthening index (LI) of 1.7 (0.9-4.4) months/cm. In the bifocal osteotomy group, the average lengthening was 7.4 (4.9-10.0) cm and with a LI of 1.0 (0.7-2.1) months/cm. The difference in LI between the groups was statistically significant, but more major complications, like persistent ankle joint contracture and pseudarthrosis in the callotasis lengthening zone, occurred with bifocal lengthening.
authors.affiliation: Oslo Orthopaedic University Clinic, National Hospital Orthopaedic Department and Biomechanics Lab, University of Oslo, Norway. leif.pal.kristiansen@rikshospitalet.no
authors.forename: Leif Pål
authors.initials: LP
authors.lastname: Kristiansen
authors.forename: Harald
authors.initials: H
authors.lastname: Steen
mesh_terms: D000293:Adolescent; D000328:Adult; D001852:Bone Lengthening / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D004869:Equipment Safety; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018889:Ilizarov Technique; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013977:Tibia / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome