title: Long-term psychosocial functioning after Ilizarov limb lengthening during childhood.
abstract: OBJECTIVE
  Few studies have been concerned with the patient's perception of the outcome of limb lengthening. We describe the psychological and social functioning after at least 2 years of follow-up in patients who had had a leg length discrepancy and who had undergone an Ilizarov limb lengthening procedure.
  
  
  METHODS
  Self-esteem and perceived competence were measured in 37 patients (aged 17-30 years) both preoperatively and at a mean follow-up of 7 (2-14) years. At follow-up, health-related quality of life, functioning at school, daily activities, and treatment-related experiences were measured, and also retrospectively for the preoperative period.
  
  
  RESULTS
  Preoperative and follow-up scores for self-esteem were similar. Overall perceived competence scores at follow-up were comparable to that of a healthy normal population. Patients' perceived athletic competence was lower and their perceived level of behavioral conduct was higher. At follow-up, patients had more positive appraisal of their physical appearance. Most health-related quality of life scores were not significantly different to those of the healthy normal population, apart from a reduced gross motor function, less vitality, and more pain. Patients with a remaining leg length inequality (LLI) of more than 2 cm had lower quality of life scores for gross motor function, sleep, pain, vitality, and depressive feelings.
  
  
  CONCLUSIONS
  At an average of 7 years after an Ilizarov limb lengthening procedure, patients still have physical restraints, but they appear to have normal psychosocial functioning, self-esteem, and perceived competence. These patients have quality of life scores comparable to those of norm groups, apart from a reduced gross motor function, less vitality and more pain. Residual LLI of more than 2 cm remains important even after long-term follow-up; these patients report lower quality of life.
authors.affiliation: Department of Paediatric Psychology, University Medical Centre Utrecht, Wilhelmina Children's Hospital, Utrecht, the Netherlands.
authors.forename: Judith M
authors.initials: JM
authors.lastname: Moraal
authors.forename: Alda
authors.initials: A
authors.lastname: Elzinga-Plomp
authors.forename: Marian J
authors.initials: MJ
authors.lastname: Jongmans
authors.forename: Peter M van
authors.initials: PM
authors.lastname: Roermund
authors.forename: Petra E
authors.initials: PE
authors.lastname: Flikweert
authors.forename: René M
authors.initials: RM
authors.lastname: Castelein
authors.forename: Gerben
authors.initials: G
authors.lastname: Sinnema
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D018889:Ilizarov Technique / Q000523:psychology* / Q000534:rehabilitation; D007870:Leg Length Inequality / Q000503:physiopathology / Q000523:psychology / Q000601:surgery; D009043:Motor Activity; D017060:Patient Satisfaction; D011788:Quality of Life; D012189:Retrospective Studies; D012649:Self Concept; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult