Korekcje zniekształceń kończyn dolnych u chorych z dysplazjami kostnymi z zastosowaniem stabilizatorów zewnętrznych / Lower limb deformities treatment with external fixators in patients with bone dysplasias
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Introduction. Multiplane axial deformities, leg length discrepancy and body disproportion are most common deformities in skeletal dysplasias patients. All of these pathologies are good indication for external Þ xation treatment with use both monolateral and circular frames. Aim of the study is to analyze results of bone deformities treatment with external fixation in patients with bone dysplasias.Material and methods. Material consists of 25 patients with different types of bone dysplasias (Ollier disease - 10, Blount disease - 7, vitamin-D resistant rickets - 2, Elis van Creveld syndrome - 2 and other - 4). Total number of 45 bone segments were treated (30 tibias, 15 femurs). Age at the beginning of treatment ranged from 7 to 20 years (mean 13,5). The main indication for treatment was axial deformity in 39 segments and LLD in 31. Mean value of deformity was 18° ranged from 8 to 43. In 6 patients short stature was additional indication for surgical treatment. Follow up ranged from 6 months to 10 years (mean 4 years, 8 months). All patients were divided into two groups according to etiology: 1. - Ollier disease, 2. other bone dysplasias.Results. Complete axial correction was achieved in all treated segments. In segments with shortening mean 5,4cm lengthening was achieved (ranged from 3 to 9). Lengthening index ranged from 1,0 to 2,2 cm/month (mean 1,43) and was statistically different in groups: 1. - 1,28 and 2. - 1,68 month/cm.Conclusions. Ilizarov distraction method is save and effective treatment of deformity correction in bone dysplasias with low rate of complications. It allows simultaneous multilevel corrections. In Ollier patients healing index is lower than in other types of bone dysplasias.
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- 1. Ilizarov GA. The main Principles of Transosseous Compression and Distraction Osteosynthesis. Orthop. Travmatol. Protez. 1971; 11: 7-15.
- 2. De Bastiani G, Aldegheri R, Renzi-Brivio L, Trivella G: Limb lengthening by callus distraction (Callotasis). J. Pediatr. Orthop. 1987; 7: 129-134.
- 3. Aronson J, Current concepts review - limb lengthening, skeletal reconstruction and bone transport with the Ilizarov method. J. Bone Joint Surg. Am. 1997; 79: 1243.
- 4. Paley D. Current Techniques of limb lengthening. J. Pediatr. Orthop. 1988; 8: 73-92.
- 5. Paley D, Herzenberg JE, Tetsworth K, Makie J, Bhave A. Deformity planning for frontal and sagittal plane corrective osteotomie. Orthop Clin North Am 1994; 25: 425-465.
- 6. Aldegheri R. Distraction osteogenesis for lengthening of the tibia in patients who have limb-length discrepancy or short stature. J. Bone Joint Surg. Am. 1999; 81: 624-634.
- 7. Bell DF, Boyer MI, Armstrong PF. The use of the Ilizarov technique in the correction of limb deformities associated with skeletal dysplasia. J. Pediatr. Orthop. 1992; 12: 283-290.
- 8. Koczewski P, Shadi M. Chirurgiczne leczenie niedoboru wzrostu o różnej etiologii metodą Ilizarowa. [Surgical treatment of short stature of different etiology by Ilizarov method]. Pediatric Endocrynology, Diabetes and Metabolism. 2007; 13, 3: 143-146.
- 9. Paley D. Problems, Obstacles and Complications of Limb Lengthening by the Ilizarov Technique. Clin. Orthop. 1990; 250: 81-104.
- 10. Naudie D, Hamdy RC, Fassier F, Duhaime M. Complications of limb-lengthening in children who have an underlying bone disorder. J Bone Joint Surg Am. 1998; 80(1): 18-24.[PubMed]
- 11. Myers GJ, Bache CE, Bradish CF. Use of distraction osteogenesis techniques in skeletal dysplasias. J Pediatr Orthop. 2003; 23(1): 41-5.[PubMed][Crossref]
- 12. Morsy A, Tsuchiya H, Matsubara H, Kabata T, Tomita K. Ilizarov deformity correction of the lower limbs in Ellis- van Creveld syndrome. J Orthop Sci. 2007;12(5): 505-9. Epub 2007 Sep 28.[PubMed][WoS][Crossref]
- 13. Jesus-Garcia R, Bongiovanni JC, Korukian M, Boatto H, Seixas MT, Laredo J. Use of the Ilizarov external fixator in the treatment of patients with Ollier’s disease. Clin Orthop Relat Res. 2001; (382): 82-6.
- 14. Watanabe K, Tsuchiya H, Sakurakichi K, Yamashiro T, Matsubara H, Tomita K. Treatment of lower limb deformities and limb-length discrepancies with the external Þ xator in Ollier’s disease. J Orthop Sci. 2007;12(5): 471-5. Epub 2007 Sep 28.[WoS][Crossref]
- 15. Kołodziej L. Kołban M, Zacha S, Chmielnicki M. The use of the Ilizarov technique In the treatment of upper limb deformity In patients with Ollier’s disease. J Pediatr Orthop 2005; 25: 202-5.[Crossref]
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