Complication, difficulties and problems in the application of distraction epiphysiolysis.
Background. Limb lengthening is a very attractive procedure in orthopedic surgery, but it is connected with a significant number of complications. Among the many methods used to lengthen limbs we studied the slow stretching of the growth plate. Material and methods. Our research involved 31 children, 18 girls and 13 boys, ranging in age from 7 to 14 years (mean 11.9), in whom epiphyseal distraction was used to lengthen 17 femoral and 14 tibial segments. The mean shortening of the leg at baseline was 6 cm. A number of complications were observed during the course of lengthening, including premature closure of the growth plate, disturbances of the limb axis, infections in the vicinity of the Kirschner wires, penetration of the wires to the knee joint, and the formation of hypoplastic regenerated bone. Results. During the mean follow-up period of 6 years,the average limb lengthening was 5 cm (range 3-8 cm), the duration averaged 110 days (range 50-160 days), the stabilization time was 48 days (30-106 days), and the mean lengthening index was 42 days/cm. Conclusions. In our opinion epiphyseal distraction is simple and relative less traumatic method of limb lengthening; however, it is associated with possible serious complications.
Katedra i Klinika Ortopedii, Akademia Medyczna, Łódź
Marek
M
Synder
Kryspin
K
Niedzielski
Andrzej
A
Borowski