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Effect of lengthening speed on the quality of callus and complications in patients with congenital pseudarthrosis of tibia

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Abstract

Purpose

This study aims to evaluate the effect of lengthening speed on the quality of callus and complications during distraction osteogenesis and describe an optimal lengthening speed in patients with congenital pseudarthrosis of tibia (CPT).

Methods

Twenty-seven patients with CPT with a minimum follow-up of 36 months who underwent limb lengthening surgery between 1997 and 2016 with external fixator only were included in this study. All patients underwent lengthening procedures after achieving complete bone union in this study. Regenerate quality is evaluated according to the Li classification on the X-ray taken one month after the end of the distraction period. Complications were noted in post-operative follow-up period. Receiver operator characteristics (ROC) curve analysis was performed to obtain optimal lengthening speed for these patients.

Result

The mean age at the time of surgery was 5.74 years. The mean lengthening speed was 0.596 mm/day. Follow-up period of 136.14 months with a mean lengthening period of 92.4 days. Mean amount of lengthening was 5.44 cm for patients with CPT. Total rate of callus with good morphological quality was calculated as 66%.

According to ROC analysis, optimal cut-off values of lengthening speed for the obtaining good morphological quality callus was 0.564 mm/day for tibial lengthening in CPT. There was a significantly positive correlation between complication rate and lengthening speed for each group.

Conclusion

We recommend a mean lengthening rate of 0.56mm/day for the lengthening procedures with external fixator in patients with CPT who had complete bone union at the area of pseudarthrosis.

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Availability of data and materials

The data that support the findings of this study are available from the corresponding author, upon reasonable request.

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Author information

Authors and Affiliations

  1. Department of Orthopedics and Traumatology, Istanbul University, Istanbul Faculty of Medicine, Turgut Özal Millet Cd, 34093, Istanbul, Turkey

    Halil İbrahim Balci, Serkan Bayram, Fikret Berkan Anarat, Levent Eralp & Cengiz Şen

  2. Department of Orthopedics and Traumatology, Emsey Hospital, Istanbul, Turkey

    Tuna Pehlivanoglu

  3. Department of Orthopedics and Traumatology, Unimed Center, Istanbul, Turkey

    Mehmet Kocaoğlu

Authors
  1. Halil İbrahim Balci
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  2. Serkan Bayram
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  3. Tuna Pehlivanoglu
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  4. Fikret Berkan Anarat
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  5. Levent Eralp
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  6. Cengiz Şen
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  7. Mehmet Kocaoğlu
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Contributions

H.İ.B.: conceived and planned the study; S.B.: drafting the manuscript; T.P.: designed and analyzed the data of manuscript; F.B.A.: acquisition of data; L.E.: critical revision; C.Ş.: revised the manuscript; M.K.: critical revision.

Corresponding author

Correspondence to Serkan Bayram.

Ethics declarations

Ethics approval

Approval was given by the institutional review board (IRB) and that informed consent was obtained from each patient (06.01.2017).

Consent to participate

Informed consent was obtained from all individual participants and their parents included in the study.

Consent for publication

Study participant consent for publication was obtained all individual participants.

Conflict of interest

The authors declare no competing interests.

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Level of evidence: Level 4 retrospective study

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Balci, H.İ., Bayram, S., Pehlivanoglu, T. et al. Effect of lengthening speed on the quality of callus and complications in patients with congenital pseudarthrosis of tibia. International Orthopaedics (SICOT) 45, 1517–1522 (2021). https://doi.org/10.1007/s00264-021-05011-7

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  • DOI: https://doi.org/10.1007/s00264-021-05011-7

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