Limb lengthening in short-stature patients using monolateral and circular external fixators.
OBJECTIVE
To review the results of distraction osteogenesis in short-stature patients in our centre and analyse outcomes including complications.


METHODS
Retrospective study.


METHODS
University teaching hospital, Hong Kong.


METHODS
Eight patients with short stature (three had achondroplasia, three constitutional short stature, and two hypochondroplasia) operated on for limb lengthening using monolateral or circular external fixators between 1995 and 2006 were reviewed.


RESULTS
The mean age at the time of surgery was 20 years (range, 9-39 years). The fixators used were either Ilizarov or Orthofix. The average gain in length per bone segment was 5.2 cm (range, 3.2-8.0 cm), and the average percentage lengthening was 21% (range, 7.9-40%). The mean time in frame was 8 months (range, 4-14 months), and the average healing index was 48 days per cm of lengthening (18-110 days per cm). Minor complications (pin tract infection and transient joint stiffness) were common, and after excluding the latter the overall complication rate was 0.6 per bone segment.


CONCLUSIONS
In our series, limb lengthening of up to 40% of the initial length of the bone segment can be achieved without significant long-term sequelae. However, the procedures were complex and prolonged, and required a special psychological approach directed at both parents and the patients. Complications are quite common, for which patients have to be well prepared before starting the procedures.
Lie
Chester W H
CW
Department of Orthopaedics and Traumatology, Duchess of Kent Children's Hospital, Pokfulam, Hong Kong. chesterliewh@gmail.com
Chow
W
W
D000293:Adolescent; D000328:Adult; D001827:Body Height; D002648:Child; D016267:External Fixators; D005260:Female; D005269:Femur / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D019857:Osteogenesis, Distraction / Q000295:instrumentation* / Q000379:methods*; D010027:Osteotomy / Q000379:methods; D011183:Postoperative Complications; D011859:Radiography; D012189:Retrospective Studies; D013977:Tibia / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome