Summary
Different methods of limb lengthening as used at the Orthopedic Surgery Clinic of the Medical School, University of Zagreb, are compared. The results of operations performed between 1979 and 1989 on 111 patients are presented. These patients were subjected to surgery aimed at length equalization of limbs and/or correction of three-dimensional deformities. Lengthening was performed in 104 patients at one level, and in 7 patients at two levels of the same limb for a total of 118 procedures. In order to compare limb lengthening techniques the patients were divided into four groups: group I, original Wagner technique (45 patients); group II, Wagner technique using corticotomy (33 patients); group III, original Ilizarov technique (35 patients); group IV, continuous lengthening (2 patients). The evaluation covered radiological aspects of regenerated bone, complications and basic lengthening parameters. The results indicate that corticotomy has considerable advantages over osteotomy, provided bone circulation is maintained. These advantages manifest themselves in a reduced number of operations, lower incidence of infection and improved bone regeneration. It is preferable to perform corticotomy at the metaphysis site because of its optimum blood supply and its higher potential for osteogenesis. With corticotomy performed at the diaphysis site, satisfactory results were observed in only one-third of the cases.
Similar content being viewed by others
References
Anderson WV (1952) Leg lengthening. J Bone Joint Surg [Br] 34:150
Aronson J, Good B, Stevart CH, Harrison B, Harp J (1990) Preliminary studies of mineralization during distraction osteogenesis. Clin Orthop 250:43
Barbarosa V (1989) Master's thesis, University of Zagreb
Brutscher R, Rüter A, Perren SM (1989) Die Behandlung ausgedehnter Defekte an langen Röhrenknochen durch Segmentverschiebung. Habilitationsschrift, Universität München
Codivilla A (1905) On means of lengthening in the lower limbs, the muscles and tissues which are shortened through deformity. Am J Orthop Surg 2:353
Coleman SS, Noonan TD (1967) Andersons method of tibial lengthening by percutaneous osteotomy and gradual distraction. J Bone Joint Surg 49:236
Delloye C, Coutelier L (1990) Bone regenerate formation in cortical bone during distraction lengthening. Clin Orthop 250:34
Fleming B, Paley D, Kristianser D, Pope M (1989) A biomechanical analysis of the Ilizarov external fixator. Clin Orthop 241:95
Goodship AE, Kenwright J (1985) The influence of induced micro-motion upon the healing of experimental tibia fractures. J Bone Joint Surg 67:650
Gross RH (1971) An evaluation of tibial lengthening procedures. J Bone Joint Surg [Am] 53:693
Ilizarov GA (1952) A method of uniting bones in fractures and an apparatus to implement this method. USSR Authorship Certificate 98471
Ilizarov GA (1968) General principles of transosteal compression and distraction osteosynthesis. In: Proceedings of scientific session of traumatology and orthopaedics, Leningrad, pp 35–39
Ilizarov GA (1989) The tension-stress effect on the genesis and growth of tissue: part I. The influence of stability of fixation and soft tissue preservation. Clin Orthop 238:249
Ilizarov GA (1989) The tension-stress effect on the genesis and growth of tissue: part II. The influence of the rate and frequency of distraction. Clin Orthop
Ilizarov GA (1990) Clinical application of the tension-stress effect for limb lengthening. Clin Orthop 250:8
Kawamura B (1981) The principles and techniques of limb lengthening. Int Orthop 5:69
Korzinek K, Barbarosa V (1988) Importance of corticotomy for bone regeneration speed in limb lengthening. Abstracts of the Intl Congress of Orthopaedics Prague, p 137
Korzinek K, Tepic S, Perren S (1990) New type of electrically driven external fixator for leg lengthening. Proceedings of the JUREMA Congress, Zagreb
Lavriceva GI, Mihailova LN (1985) Histogenesis of skeletogenetic tissue during bone regeneration under distraction. Bull Exp Biol Med 99:198
Paley D (1990) Problems, obstacles, and complications of limb lengthening by the Ilizarov technique. Clin Orthop 250:81
Paley D, Fleming B, Catagni M, Kristiansen T, Pope M (1990) Mechanical evaluation of external fixators used in limb lengthening. Clin Orthop 250:50
Putti V (1934) Operative lengthening of the femur. Surg Gynecol Obstet 58:318
Wagner H (1978) Operative lengthening of the femur. Clin Orthop 136:125
Gasser B, Boman B, Wyder D, Schneider E (1990) Stiffness characteristics of the circular Ilizarov device as opposed to conventional external fixators. J Biomech Eng 112:15–21
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Korzinek, K., Tepic, S. & Perren, S.M. Limb lengthening and three-dimensional deformity corrections. Arch Orthop Trauma Surg 109, 334–340 (1990). https://doi.org/10.1007/BF00636172
Issue Date:
DOI: https://doi.org/10.1007/BF00636172