Distraction osteogenesis using a longitudinal corticotomy.
OBJECTIVE
The purpose of this study was to evaluate whether the use of a longitudinal corticotomy (S-Z osteotomy) results in more rapid consolidation following distraction osteogenesis of short tibiae.


METHODS
Sixty-seven lengthening procedures were performed in 51 patients ranging in age from nine to 38 (mean 25) years. Diagnoses included short stature (32 tibiae), postpolio limb deformity (22 tibiae), osteomyelitis (three tibiae), trauma (two tibiae) and other diagnoses (eight tibiae). Forty-five lengthenings were performed via a longitudinal corticotomy, and 22 were performed via a transverse corticotomy. Patients were followed until consolidation of the regenerated bone was noted radiographically (consolidation time). The healing index (consolidation time per centimetre of lengthening) was calculated for each patient and compared between groups.


RESULTS
The healing index was significantly lower in the S-Z group (30.8 ± 9.6 days/cm) than in the transverse corticotomy group (46.8 ± 20.2 days/cm) (p < 0.0001). Mean lengthening was 6.6 (range 2.5-12.5) cm in the S-Z group and 5.8 (range 2.0-12.0) cm in the transverse group (p = 0.28). Mean consolidation time was 6.3 ± 2.8 (range 3-16) months in the S-Z group and 8.1 ± 3.8 (range 3-13.5) months in the transverse group (p = 0.03).


CONCLUSIONS
The S-Z osteotomy safely reduces consolidation time of regenerative bone during distraction osteogenesis in the tibia relative to a transverse corticotomy.
Orthopaedic Surgery, Centre Albert Trillat, Hôpital de la Croix-Rousse, Lyon, France. dr.alsaati@gmail.com
Ma'ad F
MF
Al-Saati
Robert A
RA
Magnussen
Sebastien
S
Lustig
Rodolphe
R
Testa
Gazal
G
Al-Saati
Faisal
F
Al-Saati
D000293:Adolescent; D000328:Adult; D001861:Bone Regeneration; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007870:Leg Length Inequality / Q000601:surgery*; D008297:Male; D019857:Osteogenesis, Distraction / Q000379:methods*; D010027:Osteotomy / Q000379:methods*; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery*; D014945:Wound Healing; D055815:Young Adult