Analysis of segmental residual growth after progressive bone lengthening in congenital lower limb deformity
| Autor: | Arnold Popkov, Dmitry Popkov, B. Pedeutour, P. Lascombes, Pierre Journeau, Thierry Haumont |
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| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Progressive bone lengthening Time Factors Adolescent Bone Lengthening Lower limb medicine Deformity Humans Orthopedics and Sports Medicine Femur Tibia Limb length discrepancy Growth Plate Child Congenital length discrepancy Children Retrospective Studies business.industry Retrospective cohort study Surgery Treatment Outcome Residual growth Child Preschool Female medicine.symptom Abnormality business Follow-Up Studies Lower Extremity Deformities Congenital |
| Zdroj: | Orthopaedicstraumatology, surgeryresearch : OTSR. 98(6) |
| ISSN: | 1877-0568 |
| Popis: | Summary Introduction The issue of prognosis in limb length discrepancy in children affected by congenital abnormality remains a subject of concern. Therapeutic strategy must take length prediction into account, to adapt equalization techniques and the timing of treatment. Initial prognosis, however, may need revising after completion of one or several surgical interventions on the pathologic limb. The aim of this study was to determine the different types of growth response that a bone segment can present after progressive lengthening in case of congenital limb length discrepancy. Materials and methods A series of 114 bone lengthenings with external fixator, performed in 36 girls and 50 boys with congenital lower limb length discrepancy, was retrospectively analyzed. Bone segment growth rates were measured before lengthening, during the first year after frame removal and finally over long-term follow-up, calculating the ratios of radiological bone length to the number of months between two measurements. Mean follow-up was 4.54 ± 0.2 years. Results Changes in short- and long-term growth rate distinguished five patterns of bone behavior after lengthening, ranging from growth acceleration to total inhibition. Discussion These five residual growth patterns depended on certain factors causing acceleration or, on the contrary, slowing down of growth: age at the lengthening operation, percentage lengthening, and minimal period between two lengthenings. These criteria help optimize conditions for resumed growth after progressive segmental lengthening, avoiding conditions liable to induce slowing down or inhibition, and providing a planning aid in multi-step lengthening programs. Level of evidence Level IV. Retrospective study. |
| Databáze: | OpenAIRE |
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