Comparison between upper and lower limb lengthening in patients with achondroplasia

Sj, Kim; Mv, Agashe; Song, Shuai; Choi, Hong‐Seok; H, Lee; Song, HR

doi:10.1302/0301-620x.94b1.27567

Cited by 35 publications

(32 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While the underlying diagnoses, limb segments lengthened, and devices used for lengthening were available for all subjects, other variables such as patient age, sex, preoperative height, and length gained were not found on a consistent basis for all studies. 7 of the 18 studies dealt with tibial lengthening only (Cattaneo et al 1988, Noonan et al 1997, McAllister et al 1999, Hahn et al 2003, Catagni et al 2005, Vaidya et al 2006, Park et al 2008), 2 studies (Venkatesh et al 2009, Kim et al 2012a) dealt with femoral lengthening alone, and the remaining 9 studies included patients undergoing combined tibial and femoral lengthening procedures. The average age of the patients at surgery was 16.3 (4–47) years and the mean follow-up time was 4.3 (0.8–16) years.…”

Section: Resultsmentioning

confidence: 99%

The etiology of short stature affects the clinical outcome of lower limb lengthening using external fixation

2014

View full text Add to dashboard Cite

Background and purposeDistraction osteogenesis (DO) has been used to gain height in short statured individuals. However, there have been no studies comparing the clinical outcome of limb lengthening based on the etiology of the short stature. We assessed whether different underlying diagnoses are associated with varied clinical outcomes in these patients.MethodsWe performed a systematic review of the literature pertaining to lower limb lengthening using external fixation for short stature. Clinical outcomes including amount of lengthening, healing index (HI), and complications based on the underlying diagnosis for the short stature were documented.Results18 clinical studies were included, with 547 patients who underwent 1,581 lower limb segment lengthening procedures. Mean follow-up was 4.3 years. The average age at lengthening was less for individuals with achondroplasia/hypochondroplasia (A/H) (14.5 years) than for those with Turner’s syndrome (TS) (18.2 years) or with constitutional short stature (CSS) (21.7 years). Mean height gained was greater in patients with A/H (9.5 cm) than in those with TS (7.7 cm) or CSS (6.1 cm) group. The HI was better in A/H (30.8 days/cm) and CSS (32 days/cm) than in TS (45.1 days/cm). The reported complication rate per segment was lower for A/H (0.68) and TS (0.71) than for CSS (1.06).InterpretationPatients with A/H tolerated larger amounts of lengthening with fewer complications than those with other diagnoses.

show abstract

Section: Resultsmentioning

confidence: 99%

The etiology of short stature affects the clinical outcome of lower limb lengthening using external fixation

2014

View full text Add to dashboard Cite

show abstract

“…Complications using monolateral fixators in humeral lengthening are less than for other long bones (Tanaka et al 1998, Hosny 2005, Shadi and Koczewski 2007, Kim et al 2012). Also, when compared with other lengthening devices, the complication rates appear to be lower with monolateral fixators.…”

Section: Discussionmentioning

confidence: 99%

“…However, the incidence is less than with lengthening in lower limbs (Kim et al 2012). We had 3 refractures (of 40) in the newly generated bone after removal of the fixator.…”

Section: Discussionmentioning

confidence: 99%

Role of hybrid monolateral fixators in managing humeral length and deformity correction

et al. 2013

View full text Add to dashboard Cite

Background and purpose Humeral lengthening and deformity correction are now being done increasingly for various etiologies. Monolateral external fixators have advantages over traditional Ilizarov circular fixators; they are easy to apply, they are less bulky, and they are therefore more convenient for the patient. We assessed the effectiveness of hybrid monolateral lateral fixators in humeral lengthening and deformity correction.Methods We retrospectively reviewed 23 patients (40 humeri) with various pathologies who underwent lengthening—with or without deformity correction using monolateral external fixator—between 2003 and 2008. Mean age at the time of the surgery was 14 (10–22) years. The mean follow-up time was 3.4 (1–7) years.Results The average duration of external fixator use was 8.3 (6–19) months. The mean lengthening achieved was 8.8 (4–11) cm and percentage lengthening was 49% (19–73). The healing index was 28 (13–60) days/cm. The major complications were refracture in 3 humeri and varus angulation of 2 humeri. The minor complications were superficial pin tract infection (6 segments), transient radial nerve palsy (1 segment), and elbow flexion contracture (5 segments). All complications resolved.Interpretation Hybrid monolateral fixators can be used for humeral lengthening and deformity correction. The advantage over circular fixators is that they are less bulky and patients can perform their day-to-day activities with the fixator in situ.

show abstract

“…Premature consolidation may be an indication of a high rate of bone formation during the lengthening process. In one study there were two premature consolidations in 24 bilateral humeral lengthening procedures [17]. The average healing index in the present series was 29.5 days/cm.…”

Section: Discussionmentioning

confidence: 59%

Humeral lengthening and deformity correction

Hosny

2016

Journal of Children's Orthopaedics

View full text Add to dashboard Cite

IntroductionIlizarov principles and hybrid fixation have improved the results of humeral lengthening. We reviewed the literature on humeral lengthening using different fixators with regard to indications, operative technique, results and complications. We also retrospectively reviewed 56 segments in 46 patients treated with humeral lengthening and deformity correction using Ilizarov external fixation. The etiology was achondroplasia (10 patients), epiphyseal injury (8 cases), infection (11 cases) and Erb’s palsy (17 cases). The average age at surgery was 14 years (range 8–20 years). The patients were assessed clinically and radiographically and DASH score was available for 36 segments. Follow-up ranged from 1−11 years. The magnitude of lengthening achieved ranged from 5−15.5 cm with an average of 9 cm. The average healing index was 29.5 cm (range 26–37 days). The percentage of area of lengthening to the original length ranged from 25 to 100% with an average of 55%. The average DASH (available for 36 segments only) score ranged from 15−40 preoperatively to 7−16 (P = 0.04) at last follow-up. Functionally, all the patients returned to their preoperative jobs and daily activities including sports.ComplicationsComplications included pin track infection in 46 segments, radial nerve palsy which recovered completely in 2 patients, fracture of the regenerate in 7 cases and premature consolidation of the regenerate in one case.ConclusionHumeral lengthening, whether unilateral or bilateral, is a valid method that improves the outcome following arm shortening and deformity correction, including angulation and rotation. Extensive lengthening up to 100% of the original length could be achieved without increasing the risk of complications.Level of evidenceIV, retrospective cohort.

show abstract

Comparison between upper and lower limb lengthening in patients with achondroplasia

Cited by 35 publications

References 25 publications

The etiology of short stature affects the clinical outcome of lower limb lengthening using external fixation

The etiology of short stature affects the clinical outcome of lower limb lengthening using external fixation

Role of hybrid monolateral fixators in managing humeral length and deformity correction

Humeral lengthening and deformity correction

Contact Info

Product

Resources

About