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Deformity correction and lengthening of lower legs with an external fixator

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Abstract

Deformities combined with shortening in 34 lower limb segments of 28 patients were treated with an Ilizarov external fixator or a Taylor spatial frame at the same level as the osteotomy. We compared an acute correction group (A) with a gradual correction group (G) in patients undergoing deformity correction followed by lengthening. We retrospectively examined the amount of deformity correction, length gained, distraction index, maturation index, and external fixation index in both groups. The mean age of subjects was 12.9 years for A, 17.9 years for G. The mean deformity correction was 17.8° for A, 25.1° for G. Mean lengthening was 5.5 cm for A, 5.0 cm for G. Mean distraction index was 16.4 days/cm for A, 10.6 days/cm for G (P<0.05). Mean maturation index was 40.5 days/cm for A, 29.5 days/cm for G (P=0.081). Mean external fixation index was 58.6 days/cm for A, 42.5 days/cm for G (P<0.05). The distraction index and external fixation index differences between the two groups were statistically significant. Gradual correction may represent a better approach than acute correction with the use of external fixators to treat deformity combined with shortening.

Résumé

Des déformations associées au raccourcissement de 34 membres inférieurs chez 28 patients étaient traités, au niveau de l’ostéotomie, avec un fixateur externe d’Ilizarof ou un cadre de Taylor. Nous avons comparés un groupe avec une correction instantanée (A) et un autre avec une correction progressive (G) de la déformation suivie de l’allongement. Nous avons mesuré rétrospectivement l’importance de la correction, le gain de longueur, les index de distraction, de maturation et de fixation externe dans les deux groupes. L’âge moyen des patients était de 12,9 ans pour le groupe A et de 17,9 ans pour le groupe G.. La correction moyenne de déformation était de 17,8° pour le groupe A et de 25,1° pour le G.. L’allongement moyen était de 5,5 cm pour le A et de 5,0 cm pour le G.. L’index de distraction était de 16,4 jours/cm pour le A et de 10,6 jours/cm pour le G. L’index de maturation était de 40,5 jours/cm pour le A et de 29,5 jours/cm pour le G. L’index de fixation externe était de 58,6 jours/cm pour le A et de 42,5 jours /cm pour le G.. La différence entre les index de distraction et de fixation externe étaient significative. La correction progressive est préférable à la correction instantanée pour traiter des déformations combinées au raccourcissement.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, School of Medicine, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan

    Hidenori Matsubara, Hiroyuki Tsuchiya, Keisuke Sakurakichi, Koji Watanabe & Katsuro Tomita

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  1. Hidenori Matsubara
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  2. Hiroyuki Tsuchiya
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  3. Keisuke Sakurakichi
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  4. Koji Watanabe
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  5. Katsuro Tomita
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Correspondence to Hiroyuki Tsuchiya.

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Matsubara, H., Tsuchiya, H., Sakurakichi, K. et al. Deformity correction and lengthening of lower legs with an external fixator. International Orthopaedics (SICOT) 30, 550–554 (2006). https://doi.org/10.1007/s00264-006-0133-8

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  • DOI: https://doi.org/10.1007/s00264-006-0133-8

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