Axial deformity correction in children via distraction osteogenesis.
We performed a retrospective analysis of the results of 62 tibial and 54 femoral lengthenings in 88 consecutive patients. The patients mean age was 13.5 years and mean follow-up was four years. There was a significant difference between metaphyseal (27+/-1.2 days/cm) and diaphyseal (39.4+/-1.7 days/cm), tibial (34+/-1.7 days/cm) and femoral (31+/-1.4 days/cm) lengthening (P<0.05), but no significant difference among the lengthening indexes when treating one-, two-, or three-dimensional deformities, congenital (34+/-2.4 days/cm) and acquired (32+/-1.0 days/cm) limb length discrepancy (LLD) (P>0.05). The lengthening index was 33+/-1.1 days/cm, distraction regenerate length 6+/-0.4 cm, and lengthening percentage 21+/-2.1. The scatter plots of new regenerate length against time and the scatter plots of neurological complication, residual deformities, broken pins, joint contractures, and hypertension rate against lengthening percentage showed a positive linear relationship (r=0.8). We found the correlations between quantitative and qualitative parameters that should help to predict the treatment outcomes. Lengthening index depends on the amount of length gained. Higher length of new bone regenerate leads to a decrease in lengthening index. Expected gain in bone length can aid in estimating the duration of treatment. The lengthening percentage correlates very well with the complication rate and can be used to predict the complication rate.
Antoci
Valentin
V
Shriners Hospitals for Children, Honolulu, HI, USA. viantoci@hotmail.com
Ono
Craig M
CM
Antoci
Valentin
V
Raney
Ellen M
EM
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005269:Femur / Q000002:abnormalities* / Q000601:surgery*; D006801:Humans; D019857:Osteogenesis, Distraction; D012189:Retrospective Studies; D013977:Tibia / Q000002:abnormalities* / Q000601:surgery*