Complications of bone lengthening

Abstract

SUMMARYBone lengthening is a surgical method which requires meticulous technique, continuous attention, and satisfactory cooperation on the part of the patient. The absence of common criteria makes it difficult both to classify the complications which arise, and to compare them with, those of other authors. We report the complications in a group of 61 patients who were studied prospectively. Disorders of the lengthening callus accounted for 45% of oil complications, and a further 33% arose in the joints. The remainder occurred in the bone, the apparatus and the soft tissues, of which the most common were stiffness of the joints, axial deviations and loosening of the pins, while articular subluxation, fractures with angulation and delayed consolidation occurred less frequently. In our study, the overall number of complications per lengthening process was 2.1. In bilateral lengthening, the rate was 1 per segment, while in unilateral cases the mean was 2.7. Problems which we defined as severe, requiring that the lengthening had to be halted, occurred in 1.8% of the total complications. The aetiology of the length discrepancy has an important role in the complications which occur in each segment. Over twice as many problems occur in asymmetrical lengthening procedures as in patients where lengthening is symmetrical. RÉSUMÉL'allongement osseux est une intervention chirurgicale qui demande une technique méticuleuse, une surveillance médicale continue et une coopération satisfaisante du patient. En l'absence de critères communs il est difficile de classer les complications et de comparer avec les résultats d'autres auteurs. Si l'on analyse les complications selon leur localisation on, constate que les problèmes concernant le cal représentent 45% du total et ceux des articulations 33%, soit un total d'environ 75% pour ces deux catégories. Les 25% restants se situent au niveau de l'os lui-même, du fixateur et des parties molles. Les incidents les plus fréquents sont les raideurs articulaires, les déviations axiales et l'ostéolyse autour des fiches, tandis que les subluxations, les fractures avec angulation et retard de consolidation s'observent moins souvent. Dans notre étude le total des complications est de 2.1 par allongement. Dans les allongements symétriques il est de 1 par segment, alors que dans les allongements asymétriques il s'élève è 2.7%. Les problèmes que nous considérons comme graves, c'est à dire ceux qui compromettent le processus d'allongement représentent 1.8% du total des complications. L'étiologie joue un rôle important dans les complications qui surviennent au niveau de chaque segment. Les complications des allongements asymétriques sont deux fois plus fréquentes que celles des allongements symétriques.

Expression of nerve growth factor and vascular endothelial growth factor in the inferior alveolar nerve after distraction osteogenesis

“…One of the ramifications of our lack of understanding is the continuing existence of associated complications, including injuries to nerve fibres after distraction. Some clinicians have detected neurosensory disturbances in up to 30% of patients who have undergone limb-lengthening procedures 1,6 . Higher sensory disturbances have also been reported in patients undergoing mandibular distraction procedures 10 .…”

ROBOImplant II: Development of a Noninvasive Controller/Actuator for Wireless Correction of Orthopedic Structural Deformities

“…After an osteotomy, the external brace is lengthened gradually, typically millimeters per session, until the desired length is reached. External fixation, however, suffers from many drawbacks including mechanical failures of the brace, surgical complications from frequent tuning sessions, high risk for infections, long procedure durations, and the unwieldiness of external braces and rods [4].…”

Distraction osteogenesis using a longitudinal corticotomy

“…Early treatment techniques had high complication rates, and optimal results were rare [3,17]. In the 1950s, Ilizarov describe distraction osteogenesis, a technique based on the biology of bone regeneration [7,8].…”