Tibial lengthening with a submuscular plate in adolescents

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• 作者：Chang-Wug Oh ; Seung-Gil Baek ; Joon-Woo Kim ; Jeong-Woo Kim
• 刊名：Journal of Orthopaedic Science
• 出版年：2015
• 出版时间：January 2015
• 年：2015
• 卷：20
• 期：1
• 页码：101-109
• 全文大小：840 KB
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  19. Sun XT, Easwar TR, Manesh S, Ryu JH, Song SH, Kim SJ, Song HR. Complications and outcome of tibial lengthening using the Ilizarov method with or without a supplementary intramedullary nail: a case-matched comparative study. J Bone Jt Surg Br. 2011;93:782-.
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Orthopedics
  Surgical Orthopedics
  Conservative Orthopedics
  Rheumatology
  Sports Medicine
  
• 出版者：Springer Japan
• ISSN：1436-2023

文摘

Background Lengthening over an intramedullary nail has become a common technique for reducing the period of external fixation. However, the technique presents difficulties in patients with an open physis or a small marrow canal. Lengthening using a submuscular plate offers a new substitute in such situations, but few studies have been undertaken to determine its efficacy in teenagers. Patients and methods A retrospective review was performed on 20 consecutive tibiae of 16 patients who underwent tibial lengthening with the aid of external fixator and submuscular plate. Charts and radiographs were reviewed for demographics, surgical details, and complications related to the technique. Results The average age of the 16 patients was 14.3?years (range 10-7), and the amount of lengthening averaged 4.1?cm (range 3.0-.0?cm), which represented 12.7?% of preoperative bone length (range 9.1-5.8?%). Mean time in the fixator was 60.3?days, mean external fixation index was 14.8?days/cm (range 13.2-2.5?days/cm), and mean healing index was 49.1?days/cm (range 37-9.3?days/cm). Twenty-seven complications occurred giving an overall complication rate of 1.35. Twenty of the 27 were minor complications, but 7 were major. These major complications were resolved surgically or by a resolution period exceeding 3?months. There were 3 cases of transient angular deformity of distraction callus, 2 cases of transient peroneal nerve palsy, 1 case of clamp loosening, and 1 case of plate failure. Functional results were good or excellent with an average score of 95.6 according to modified Paley’s criteria. Conclusions Although complications were not uncommon, tibial lengthening with a submuscular plate proved to be a reliable technique for treating limb length discrepancy in adolescents with reduced external fixation duration. Level of evidence Level IV, case series.