Limits...
Limb lengthening over plate.

Kulkarni R, Singh N, Kulkarni GS, Kulkarni M, Kulkarni S, Kulkarni V - Indian J Orthop (2012)

Bottom Line: The preoperative target length was successfully achieved in all patients at a mean of 4.1 cm (range 1.8-6.5 cm).The mean duration of external fixation was 75.3 days (range 33-116 days) with the mean external fixation index at 19.2 days/cm (range 10.0-38.3 days/cm).Lengthening over plate is also applicable to children with open physis.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Fracture and Orthopaedic Hospital, Post Graduate Institute of Swasthiyog Pratisthan, Miraj, Maharashtra, India.

ABSTRACT

Background: The limb lengthening over plate eliminates the associated risk of infection with limb lengthening over intramedullary nail. We present our experience of limb lengthening in 15 patients with a plate fixed on the proximal segment, followed by corticotomy and application of external fixator.

Materials and methods: 15 patients (7 females, 8 males) were included in this consecutive series. The average age was 18.1 years (range 8-35 years). Fifteen tibiae and one femur were lengthened in 15 patients. Lengthening was achieved at 1 mm/day followed by distal segment fixation with three or four screws on reaching the target length.

Results: The preoperative target length was successfully achieved in all patients at a mean of 4.1 cm (range 1.8-6.5 cm). The mean duration of external fixation was 75.3 days (range 33-116 days) with the mean external fixation index at 19.2 days/cm (range 10.0-38.3 days/cm). One patient suffered deep infection up to the plate, three patients had mild procurvatum deformities, and one patient developed mild tendo achilles contracture.

Conclusion: Lengthening over a plate allows early removal of external fixator and eliminates the risk of creating deep intramedullary infection as with lengthening over nail. Lengthening over plate is also applicable to children with open physis.

No MeSH data available.


Related in: MedlinePlus

(a) Plate placed externally over the bone; (b) plate position viewed under fluoroscope to confirm correct position of plate
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3377147&req=5

Figure 1: (a) Plate placed externally over the bone; (b) plate position viewed under fluoroscope to confirm correct position of plate

Mentions: With the patient supine on a radiolucent table, fibular osteotomy was done 7 cm above the lateral malleolus. Following this, a 3.5/4.5 mm LCDCP (Pitkar, Pune, India) was placed externally over the medial surface of the bone around the proposed lengthening site [Figure 1a] and viewed under a fluoroscope [Figure 1b]. The plate on the tibia was placed over the medial surface. The plate was slid extraperiosteally through a small vertical incision at the planned corticotomy site so that plate insertion and corticotomy could be done through one incision. Also, no muscle dissection was required as would have been needed for lateral plating. We had only one complication of plate prominence, and so we prefer the medial surface for the tibia. Over the femur, the plate was placed on the lateral surface. The plate was positioned such that there were at least three holes distal to the planned corticotomy after taking into account the proposed lengthening and three holes proximal to the corticotomy.


Limb lengthening over plate.

Kulkarni R, Singh N, Kulkarni GS, Kulkarni M, Kulkarni S, Kulkarni V - Indian J Orthop (2012)

(a) Plate placed externally over the bone; (b) plate position viewed under fluoroscope to confirm correct position of plate
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3377147&req=5

Figure 1: (a) Plate placed externally over the bone; (b) plate position viewed under fluoroscope to confirm correct position of plate
Mentions: With the patient supine on a radiolucent table, fibular osteotomy was done 7 cm above the lateral malleolus. Following this, a 3.5/4.5 mm LCDCP (Pitkar, Pune, India) was placed externally over the medial surface of the bone around the proposed lengthening site [Figure 1a] and viewed under a fluoroscope [Figure 1b]. The plate on the tibia was placed over the medial surface. The plate was slid extraperiosteally through a small vertical incision at the planned corticotomy site so that plate insertion and corticotomy could be done through one incision. Also, no muscle dissection was required as would have been needed for lateral plating. We had only one complication of plate prominence, and so we prefer the medial surface for the tibia. Over the femur, the plate was placed on the lateral surface. The plate was positioned such that there were at least three holes distal to the planned corticotomy after taking into account the proposed lengthening and three holes proximal to the corticotomy.

Bottom Line: The preoperative target length was successfully achieved in all patients at a mean of 4.1 cm (range 1.8-6.5 cm).The mean duration of external fixation was 75.3 days (range 33-116 days) with the mean external fixation index at 19.2 days/cm (range 10.0-38.3 days/cm).Lengthening over plate is also applicable to children with open physis.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Fracture and Orthopaedic Hospital, Post Graduate Institute of Swasthiyog Pratisthan, Miraj, Maharashtra, India.

ABSTRACT

Background: The limb lengthening over plate eliminates the associated risk of infection with limb lengthening over intramedullary nail. We present our experience of limb lengthening in 15 patients with a plate fixed on the proximal segment, followed by corticotomy and application of external fixator.

Materials and methods: 15 patients (7 females, 8 males) were included in this consecutive series. The average age was 18.1 years (range 8-35 years). Fifteen tibiae and one femur were lengthened in 15 patients. Lengthening was achieved at 1 mm/day followed by distal segment fixation with three or four screws on reaching the target length.

Results: The preoperative target length was successfully achieved in all patients at a mean of 4.1 cm (range 1.8-6.5 cm). The mean duration of external fixation was 75.3 days (range 33-116 days) with the mean external fixation index at 19.2 days/cm (range 10.0-38.3 days/cm). One patient suffered deep infection up to the plate, three patients had mild procurvatum deformities, and one patient developed mild tendo achilles contracture.

Conclusion: Lengthening over a plate allows early removal of external fixator and eliminates the risk of creating deep intramedullary infection as with lengthening over nail. Lengthening over plate is also applicable to children with open physis.

No MeSH data available.


Related in: MedlinePlus