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Bone lengthening with extra-articular arthrodesis of the hip using external fixation.

Mesa PA - Strategies Trauma Limb Reconstr (2008)

Bottom Line: Clinical review indicated a significant improvement in physical function and psychological well-being.Complications were more frequent in patients older than 14 years (P = 0.034) as was a higher maturation index (P = 0.021).No additional operations were required to achieve the surgical objective.

View Article: PubMed Central - PubMed

Affiliation: Clinic of Niño ISS "Jorge Bejarano" and Clinic 104 Saludcoop "Jorge Piñeros", Calle 175 No. 17A-11(135), Bogotá, Colombia, pasm@clubcadera.com.

ABSTRACT
This is a case series of 11 children and adolescents who underwent femoral lengthening and percutaneous hip arthrodesis using a method of extra-articular joint compression in combination with callotasis. Clinical review indicated a significant improvement in physical function and psychological well-being. The average lengthening was 5.3 cm or 16% of the initial length. Complications were more frequent in patients older than 14 years (P = 0.034) as was a higher maturation index (P = 0.021). No additional operations were required to achieve the surgical objective.

No MeSH data available.


Related in: MedlinePlus

a Arthrodesis of the hip now complete. b Final lengthening and percentage length gained. c A 11-year old child with limb length symmetry and post-hip arthrodesis
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Fig5: a Arthrodesis of the hip now complete. b Final lengthening and percentage length gained. c A 11-year old child with limb length symmetry and post-hip arthrodesis

Mentions: All patients attended weekly for clinical and radiological review during the period of lengthening and hip compression. Advice on maintaining knee extension and attendance to a regular physiotherapy programme was given. When the required lengthening was achieved, the external fixator was locked and a dynamiser (Dynaring. Orthofix SRL, Verona, Italy) inserted. Patients were also encouraged to increase their activity levels and weight-bearing (Fig. 5). This period coincided with an emphasis on recovery of knee function and range of movement. Some patients (older than 16 years) were provided additional stimulation through an electro-magnetic bracelet which was used for 1 h daily over the regenerate zone. On completion of treatment the external fixator and screws were extracted as an out-patient procedure in 80% of cases; this was carried out when three out of four cortices were visible within the regenerate column in AP and lateral radiographs. Plaster of Paris casts or orthotic splints were not used after fixator removal. Strengthening with physiotherapy was commenced 15 days after fixator removal.Fig. 5


Bone lengthening with extra-articular arthrodesis of the hip using external fixation.

Mesa PA - Strategies Trauma Limb Reconstr (2008)

a Arthrodesis of the hip now complete. b Final lengthening and percentage length gained. c A 11-year old child with limb length symmetry and post-hip arthrodesis
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2553433&req=5

Fig5: a Arthrodesis of the hip now complete. b Final lengthening and percentage length gained. c A 11-year old child with limb length symmetry and post-hip arthrodesis
Mentions: All patients attended weekly for clinical and radiological review during the period of lengthening and hip compression. Advice on maintaining knee extension and attendance to a regular physiotherapy programme was given. When the required lengthening was achieved, the external fixator was locked and a dynamiser (Dynaring. Orthofix SRL, Verona, Italy) inserted. Patients were also encouraged to increase their activity levels and weight-bearing (Fig. 5). This period coincided with an emphasis on recovery of knee function and range of movement. Some patients (older than 16 years) were provided additional stimulation through an electro-magnetic bracelet which was used for 1 h daily over the regenerate zone. On completion of treatment the external fixator and screws were extracted as an out-patient procedure in 80% of cases; this was carried out when three out of four cortices were visible within the regenerate column in AP and lateral radiographs. Plaster of Paris casts or orthotic splints were not used after fixator removal. Strengthening with physiotherapy was commenced 15 days after fixator removal.Fig. 5

Bottom Line: Clinical review indicated a significant improvement in physical function and psychological well-being.Complications were more frequent in patients older than 14 years (P = 0.034) as was a higher maturation index (P = 0.021).No additional operations were required to achieve the surgical objective.

View Article: PubMed Central - PubMed

Affiliation: Clinic of Niño ISS "Jorge Bejarano" and Clinic 104 Saludcoop "Jorge Piñeros", Calle 175 No. 17A-11(135), Bogotá, Colombia, pasm@clubcadera.com.

ABSTRACT
This is a case series of 11 children and adolescents who underwent femoral lengthening and percutaneous hip arthrodesis using a method of extra-articular joint compression in combination with callotasis. Clinical review indicated a significant improvement in physical function and psychological well-being. The average lengthening was 5.3 cm or 16% of the initial length. Complications were more frequent in patients older than 14 years (P = 0.034) as was a higher maturation index (P = 0.021). No additional operations were required to achieve the surgical objective.

No MeSH data available.


Related in: MedlinePlus