Skip to main content

Advertisement

SpringerLink
Log in

Correction of deformity and shortening due to post traumatic epiphyseal arrest by distraction osteogenesis

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Growth arrest in the epiphyseal plate during childhood often causes both periarticular deformities and limb length discrepancy, leading to compartmental osteoarthrosis and gait disturbance or spinal disorders, respectively. Distraction osteogenesis using external fixators with hinge systems appears to be useful for the simultaneous correction of deformity and shortening. In this paper, we evaluated cases of lower limbs with periarticular deformities and limb length discrepancy after epiphyseal plate injury that has been treated by distraction osteogenesis using external fixators. This is the first report regarding the outcomes of distraction osteogenesis for a group of patients having deformity and limb length discrepancy due to traumatic arrest of the physis. Successful outcomes may promise the use of this method as the first choice for the treatment of growth disorders after the arrest of the epiphyseal plate in the lower limbs. However, treatment under 20 years of age may provide a better outcome with a lower incidence of complications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Bhave A, Paley D, Herzenberg JE (1999) Improvement in gait parameters after lengthening for the treatment of limb-length discrepancy. J Bone Joint Surg Am 81:529–534

    PubMed  CAS  Google Scholar 

  2. Birch JG, Samchukov ML (2004) Use of the Ilizarov method to correct lower limb deformities in children and adolescents. J Am Acad Orthop Surg 12:144–154

    PubMed  Google Scholar 

  3. Gurney B (2002) Leg length discrepancy. Gait Posture 15:195–206

    Article  PubMed  Google Scholar 

  4. Hantes ME, Malizos KN, Xenakis TA, et al (2001) Complications in limb-lengthening procedures: a review of 49 cases. Am J Orthop 30:479–483

    Article  PubMed  CAS  Google Scholar 

  5. Hasler C, von Laer L (2000) [Pathophysiology of posttraumatic deformities of the lower limbs during growth]. Orthopade 29:757–765

    Article  PubMed  CAS  Google Scholar 

  6. Herbert A, Herzenberg J, Paley D (1995) A review for pediatricians on limb lengthening and the Ilizarov method. Curr Opin Pediatr 7:98–105

    Article  PubMed  CAS  Google Scholar 

  7. Herzenberg J (2002) Rotation and angulation-rotation deformities. In: Paley D (ed) Principles of deformity correction. Springer, Heidelberg pp235–268

    Google Scholar 

  8. Ilizarov GA (1990) Clinical application of the tension-stress effect for limb lengthening. Clin Orthop 250:8–26

    PubMed  Google Scholar 

  9. Kakushima M, Miyamoto K, Shimizu K (2003) The effect of leg length discrepancy on spinal motion during gait: three-dimensional analysis in healthy volunteers. Spine 28:2472–2476

    Article  PubMed  Google Scholar 

  10. Kamegaya M, Shinohara Y, Shinada Y (1996) Limb lengthening and correction of angulation deformity: immediate correction by using a unilateral fixator. J Pediatr Orthop 16:477–479

    PubMed  CAS  Google Scholar 

  11. Kettelkamp DB, Hillberry BM, Murrish DE, et al (1988) Degenerative arthritis of the knee secondary to fracture malunion. Clin Orthop 159–169

  12. Maffulli N, Lombari C, Matarazzo L et al (1996) A review of 240 patients undergoing distraction osteogenesis for congenital post-traumatic or postinfective lower limb length discrepancy. J Am Coll Surg 182:394–402

    PubMed  CAS  Google Scholar 

  13. McKellop HA, Llinas A, Sarmiento A (1994) Effects of tibial malalignment on the knee and ankle. Orthop Clin North Am 25:415–423

    PubMed  CAS  Google Scholar 

  14. Paley D (1990) Problems, obstacles, and complications of limb lengthening by the Ilizarov technique. Clin Orthop Relat Res 81–104

  15. Paley D, Herzenberg JE, Tetsworth K et al (1994) Deformity planning for frontal and sagittal plane corrective osteotomies. Orthop Clin North Am 25:425–465

    PubMed  CAS  Google Scholar 

  16. Paley D, Tetsworth K (1992) Mechanical axis deviation of the lower limbs. Preoperative planning of uniapical angular deformities of the tibia or femur. Clin Orthop 48–64

  17. Sharma L, Song J, Felson DT et al (2001) The role of knee alignment in disease progression and functional decline in knee osteoarthritis. Jama 286:188–195

    Article  PubMed  CAS  Google Scholar 

  18. Skak S, Macnicol M (2000) A clinical approach to the assessment of physeal injuries. Current Orthop 14:267–277

    Article  Google Scholar 

  19. Tetsworth K, Paley D (1994) Malalignment and degenerative arthropathy. Orthop Clin North Am 25:367–377

    PubMed  CAS  Google Scholar 

  20. Tsuchiya H, Uehara K, Abdel-Wanis ME et al (2002) Deformity correction followed by lengthening with the Ilizarov method. Clin Orthop 176–183

  21. Yasui N, Kawabata H, Kojimoto H et al (1997) Lengthening of the lower limbs in patients with achondroplasia and hypochondroplasia. Clin Orthop 298–306

  22. Yasui N, Nakase T, Kawabata H et al (2000) A technique of percutaneous multidrilling osteotomy for limb lengthening and deformity correction. J Orthop Sci 5:104–107

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hoshigaoka Kouseinenkin Hospital, 4-8-1, Hoshigaoka, Hirakata, Osaka, 573-8511, Japan

    Takanobu Nakase

  2. Department of Orthopaedic Surgery, Tokushima University School of Medicine, Tokushima, Japan

    Natsuo Yasui

  3. Department of Orthopaedic Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan

    Hidehiko Kawabata

  4. Department of Orthopaedic Surgery, Minamiosaka Ryouikuen, Osaka, Japan

    Nobuyuki Shimizu

  5. Department of Orthopaedic Surgery, Kansai Rousai Hospital, Hyogo, Japan

    Kenzi Ohzono

  6. Department of Orthopaedic Surgery, National Hospital Organization, Osaka National Hospital, Osaka, Japan

    Kauzo Hiroshima

  7. Department of Orthopaedic Surgery, Osaka University Medical School, Osaka, Japan

    Hideki Yoshikawa

Authors
  1. Takanobu Nakase
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Natsuo Yasui
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hidehiko Kawabata
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nobuyuki Shimizu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kenzi Ohzono
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kauzo Hiroshima
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hideki Yoshikawa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Takanobu Nakase.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nakase, T., Yasui, N., Kawabata, H. et al. Correction of deformity and shortening due to post traumatic epiphyseal arrest by distraction osteogenesis. Arch Orthop Trauma Surg 127, 659–663 (2007). https://doi.org/10.1007/s00402-007-0339-2

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-007-0339-2

Keywords

Search

Navigation