title: Pediatric lower limb Ilizarov lengthening with functional evaluation in adulthood: A report on underprivileged patients.
abstract: OBJECTIVE
  Ilizarov lengthening, with the principles of Ilizarov, requires a collaboration and supervision of the physiotherapist, nurse, and psychologist, preferably in a group-therapy set-up. We report the mid- and long-term functional outcome of cases that had none of the above listed supporting elements. In addition, we tried to observe the effect of the disease category on the final outcome in the patient.
  
  
  METHODS
  In this study, 35 children who had undergone Ilizarov lower limb lengthening were evaluated using the following methods: clinical, radiographic, and by four functional scoring systems, and parent/patient satisfaction questionnaires, after an average of 17.2 years (10-25 years).
  
  
  RESULTS
  In this study, 19 boys and 16 girls aged 5-16 years received 18 femoral and 20 tibial lengthening. An average of 6.2 cm lengthening in the femur and 8.4 in the tibia was achieved, with a healing index of 26.5 days. The disease category did not significantly affect the healing index, but the complications, 0.5 per femoral and 0.7 per tibial segment, were more common among congenital, and least among post-traumatic discrepancies. A complete improvement in joint stiffness was observed by 6-12 months post-frame removal in 83% of the cases, following home therapy by parents alone.
  
  
  CONCLUSIONS
  The long-term results of Ilizarov lengthening for lower limb discrepancy in children, even without group-therapy or good supportive aids, can improve function and maintain patient satisfaction in two thirds of the cases, over an average period of 17 years.
  
  
  METHODS
  IV.
authors.affiliation: Orthopaedic Research Centre, Department of Orthopaedics, Namazee Hospital, Shiraz Medical University, Shiraz 7193711351, Iran.
authors.forename: Gholam Hossain
authors.initials: GH
authors.lastname: Shahcheraghi
authors.affiliation: Orthopaedic Research Centre, Department of Orthopaedics, Namazee Hospital, Shiraz Medical University, Shiraz 7193711351, Iran.
authors.forename: Mahzad
authors.initials: M
authors.lastname: Javid
authors.affiliation: Orthopaedic Research Centre, Department of Orthopaedics, Namazee Hospital, Shiraz Medical University, Shiraz 7193711351, Iran.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Hadavi
keywords: Bone lengthening; Exercise therapy; Ilizarov technique; Lower extremity; Outcome assessment (health care)