The fracture lines in Milch type II fractures of lateral humeral condyle with concomitant posteromedial elbow dislocation extend to the lower medial part of the trochlea. The soft tissue injuries are more badly so that longer time needed to regain full range of elbow movement. Initial recognition of this rare injury is essential to regain satisfactory functional outcomes.

Purpose The purpose of this study was to explore the clinical effect of the novel method combined longitudinal S-osteotomy and Lengthen And Then Nail (LATN) technique for leg lengthening and compare with the classic Ilizarov method. Methods This retrospective study was performed from March 2008 to April 2012. A total of 176 leg lengthenings (88 consecutive patients) were performed at our institution. The mean duration of follow-up was 2.2 years (range, one to four years). In group A, 78 tibial lengthenings were performed with longitudinal S-osteotomy and LATN technique. In group B, 98 tibial lengthenings were performed with the classic method. The final gain in length, mean surgical time for bilateral tibial osteotomy, the external fixation index and the radiographic consolidation index were calculated and compared. The complications encountered during operation and follow-up were documented. Results There was no significant difference in the final gain in length between the two groups. Mean surgical time in group A (130.05±6.60 min) was significantly longer than that in group B (91.4±6.61 min; P<0.05). External fixation index in group A (21.02±3.16 days/cm) was significantly lower than that in group B (76.19±8.32 days/cm; P<0.05). Consolidation index was significantly lower (more rapid healing) in group A (43.38±5.35 days/cm) than that in group B (76.19±8.32-days/cm; P<0.05). There was a significant difference in pintract problems and axial deviation between the two groups. Conclusion The novel method combined longitudinal Scorticotomy and LATN technique safely reduces the consolidation time, rate of pin-tract problems and axial deviation during leg lengthening, compared with the classic Ilizarov method.

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