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Results for “LEG LENGTHENING”

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PubMed2004

Hydroxyapatite-coated external-fixation pins. The effect on pin loosening and pin-track infection in leg lengthening for short stature.

Pin loosening and infection are inherent complications of external fixation. This study deals with their effects of using either hydroxyapatite (HA)-coated or uncoated external fixation pins in leg-lengthening procedures on patients of short stature. We used HA-coated pins on one side and uncoated pins on the other (randomly determined) in 28 bilateral lengthenings undertaken in 23 patients. A total of 322 pins was used. The mean implantation time was 530 days and the mean lengthening achieved was 78% of initial bone length. Mean extraction torque was 7611.6 Nmm degree(-1) for HA-coated and 85.4 Nmm degree(-1) for uncoated pins (p < 0.001). The rate of pin loosening was 4% (7/161) for HA-coated and 80% (129/161) for uncoated pins (p < 0.001). There was no statistically significant difference in the incidence of pin-track infection between the two groups. The use of HA coating appears to be an effective method of reducing the incidence of pin loosening in external fixation with a long implantation time and for mechanically highly stressed procedures such as leg lengthening for short stature.

Adolescent↗
PubMed1977

[Results of animal experiments with an implantable femur distractor for operative leg lengthening (author's transl)].

A new femur distractor for operative leg lengthening has been developed. The new instrument consists of an electronically controllable distractor set including a power unit and a two-part guide rail. The whole system can be implanted totally and gives rigid fixation throughout the period of distraction. The operations "forward motion", "stop" and "backward motion" can be regulated transcutaneously by radio control. A prototype especially developed for animal experiments has been tested successfully in sheep.

Animals↗
PubMed2000

The psychological and social functioning of 14 children and 12 adolescents after Ilizarov leg lengthening.

We studied the psychological and social impact of the Ilizarov leg lengthening procedure in 26 patients (aged 6-17 years), who had completed the treatment at least 2 months previously. Measurements of depression and anxiety were performed preoperatively and at follow-up. Questions about functioning at school, daily life activities and treatment-related experiences were answered by the patient and his/her parents. The school or work results showed no significant decline during the lengthening procedure. Serious sleeping problems occurred during the procedure. There was no subjective improvement in physical skill after the procedure and almost one-fourth of the children still had complaints about their leg. We conclude that the Ilizarov procedure caused no serious psychological disturbances.

Adolescent↗
PubMed1990

Computer-aided manipulation of photographs for leg lengthening.

The use of composite photographs to aid the patient and the consultant to assess the visual effects of different degrees of leg lengthening is now a well-established practice at the Royal Hallamshire Hospital, Sheffield. The original photographic composite technique was both time consuming and intricate. By the use of the Apple Macintosh computer and software such as Digital Darkroom, major advances over the old technique have been achieved resulting in a more accurate representation of what is hoped will be the final operative appearance.

Bone Lengthening↗
PubMed1964

[LEG LENGTHENING].

Explore the source record for details and available documents.

Bone Lengthening↗
PubMed1996

Callus formation in femur and tibia during leg lengthening: 7 patients examined with DXA.

We examined the callus formation during leg lengthening in 7 achondroplastic patients who underwent 3 bilateral femoral and 4 bilateral tibial lengthenings. Bone mineral content and bone mineral density (BMD) in the lengthened callus space were evaluated every 1 or 2 weeks for 10 weeks after the start of distraction using dual energy X-ray absorptiometry. The mean rate of callus mineralization in femurs (0.64 g/wk) was higher than in tibias (0.22 g/wk). The mean BMD at 10 weeks after the start was 0.35 g/cm2 in the femur and 0.14 g/cm2 in the tibia. Different rates of callus formation in different kinds of long tubular bones have not been reported previously.

Achondroplasia↗
PubMed1976

[Osseous bridging of the distraction gap in leg lengthening procedures (author's transl)].

The bony refill of the distraction-space in leg-lengthening operations is analysed by X-ray control and histological technic as well in animal experiments as clinical patients. Based on our observations a theory of the formation of bone is postulated: We figured out, that a) presumable besides the periosteal potentials of bone formation there are also other active mechanisms of bone growth to be found. b) frequently histological recognised formations of bones cannot yet be proved by X-ray, that means, that the X-ray changes follow the histological ones. c) optimal formation of callus needs most possible stability during the time of consolidation. d) most careful distraction prevents deformities.

Adolescent↗
PubMed1988

[Wagner's method of leg lengthening in young children].

In 22 children under the age of 10 years a Wagner leg-lengthening procedure was started at a time when the orthosis became a nuisance. In all cases a discrepancy of more than 7.5 cm was expected at the end of growth, and an end result with full weight bearing and a minimal adjustment seemed to be within reach. In 9 children this aim has already been attained, 12 children are still under treatment and one child withdrew after a femoral lengthening complicated by an ankylotic hip joint. An account is given of a total of 35 procedures (16 tibiae, 19 femora). Complications can be prevented, or at least controlled, by careful lengthening, not exceeding 15-20% of the original length of the bone. The technique of diaphyseal callus-distraction reduced the gap-healing time to less than 6 months, while it diminished the need for cancellous bone-grafts and internal fixation. Furthermore, in at least 4 patients such a growth stimulus was observed after femoral lengthening, that a second procedure was not necessary.

Bone Diseases, Developmental↗
PubMed2004

[Circulation changes depending on manifestations in soft tissue tensioning in the leg lengthening process].

Surgical intervention was found to intensify circulation in the limb and redistribute the blood flow. Leg lengthening led to arterial inflow limitation due to the magisterial artery strain. The changes were accompanied both by increase of functioning capillaries in number and increase of venous outflow dependence on blood inflow. The decreased after surgery oxygen tension in m. gastrocnemius did not change throughout distraction. The increase of functioning capillaries in number in resting contributed to maintenance of tissue oxygenation in the initial period of distraction, and in case of maximal tissue tensioning hydrostatic pressure increased in the capillaries due to arterial pressure rise. Restoration of the circulation parameters in the fixation period started with an increase of circulation volumetric rate in vessels with preservation of the rest mechanisms of the tissue oxygenation maintenance.

Animals↗
PubMed1996

Reliability of radiological measurements of the distraction gap during leg lengthening.

PURPOSE: The aim of this study was to determine the accuracy of length measurements on plain radiographs during leg lengthening and to evaluate a reliable method of measuring the amount of lengthening suitable for clinical praxis. MATERIAL AND METHODS: In an experimental study, a plastic femur was lengthened 40 mm and assessed radiographically in different positions, and the orthoradiographically calculated total length of the femur was compared with the true value. In a clinical study, 96 radiographs encompassing 14 femoral and 2 tibial lengthenings were assessed on a digitized table with a computer program (PROFILE) with regard to the amount of lengthening and the degree of magnification. RESULTS: The radiographic magnification in the experimental study, depending on position of the femur, was 17% (5-25%), and in the clinical material it averaged 16% (0-36%). CONCLUSION: Radiographs obtained with a radiopaque ruler placed at the same level as the lengthened bone allowed reliable measurements of the distraction gap.

Adolescent↗
PubMedDate not supplied

Bone remodeling after leg lengthening: evaluation with plain radiographs, and computed tomography and magnetic resonance imaging scans.

Ten patients who had undergone leg lengthening were monitored with plain radiographs and computed tomography (CT) scans at 3-month intervals. Four of them were examined with magnetic resonance imaging (MRI) scans. When the external fixator was removed, MRI scans could not demonstrate any continuous fat signals in the lengthened region, suggesting the lack of medullary cavity. CT scans disclosed double cortex in three patients and irregular new bone formation in seven. At 6 months, a medullary cavity could be detected. Other aberrations were less evident. Remodeling of new bone material required at least 1 year.

Adolescent↗
PubMed1997

Intraoperative arthrography and the Ilizarov technique. Role in the correction of paediatric deformity and leg lengthening.

We performed intraoperative arthrography of the knee in 12 children with congenital short femur, Blount's disease or Ollier's disease in whom the Ilizarov technique was used for correction of deformity, leg lengthening or both. In each case, arthrography revealed a joint surface considerably different from that assumed from plain radiographs, and resulted in a change in the placement of our reference wires before application of the frame. This gave significant improvement in the mechanical axis obtained at the time of removal of the frame. The technique is safe, cheap and easy to perform. It is a useful adjunct to the application of the Ilizarov frame when used for complex lengthening and correction of deformity in the leg.

Arthrography↗
PubMed1999

Biomechanical properties of tendons during lower-leg lengthening in dogs using the Ilizarov method.

Ten dogs were provided with a circular fixator. Segment resection of the fibula and tibial osteotomy in the right lower leg was performed. 5 days after surgery, a lengthening of the right lower leg by 2.5 cm was performed on 6 dogs using a distraction rate of 0.5 mm, twice per day. 3 dogs with leg lengthening and 2 dogs of the control group without leg lengthening were sacrificed at the end of the distraction phase of 25 days and the remaining dogs after another 25 days. Postmortally the tendons of the tibialis anterior, extensor digitorum longus, peroneus longus and the achilles tendon were taken from the operated right side and the left non-operated control side and were examined biomechanically in cyclic tests. The control group without lengthening showed no changes in the biomechanical properties in the tendons of either side nor in those of the unlengthened left side of the operated dogs. In contrast the biomechanical tests revealed a marked decrease of the elastic modulus, an increase of distraction length and an increase of modulus reduction on the lengthened side compared to the non-operated left side.

Animals↗
PubMed1976

Leg lengthening with a new type of external fixator (a preliminary report on 24 cases).

A new type of external fixator bas been designed for absolute fixation and prevention of lateral migration of fragments of bone. The apparatus has been used for leg lengthening. The apparatus and the technique are described and results of the first 24 cases are presented. Complications were minimal. The technique proved to be simple to apply, and painless to the patient with his ambulation from the start. And less expense are involved because of a very short period of hospitalization.

Adolescent↗
PubMed2001

[Reduction of the period of treatment for leg lengthening. Technique and advantages].

PURPOSE OF THE STUDY: We assessed an adaptation of the Ilizarov method aimed at a considerable reduction in the period of treatment for leg lengthening in order to limit complications related to the duration of the external fixation. This technique associates multiple segment lengthening, automatic high-frequency lengthening, and stimulation of bone regeneration by extemporaneous compression at the end of traction. MATERIAL AND METHODS: We analyzed 78 cases of automatic fémur lengthening in 40 patients and simultaneous fémur and tibia lengthening in 38 patients. There were 51 men and 27 women, mean age 13.2 years (6 - 43 years). Mean length deficiency was 4.3 cm for the fémur and 3.5 cm for the tibia. Femoral and/or tibial deformations were observed in 32 patients. Minimal follow-up was 1.5 years. The automatic traction device was composed of the conventional Ilizarov fixator and complementary elements. Different assemblies were used depending on the associated deformations allowing their progressive correction. For 17 patients, radioimmunoassay of thyrocalcitonin and parathormone was performed to compare the time courses. RESULTS: Mean femoral lengthening achieved was 49 mm (8.5 to 20%). Mean tibial lengthening was 42 mm (7.2 to 18.8%). The consolidation index was 18.1 to 21.3 days/cm for single-segment lengthenings and 11.5 days/cm (mean) for two-segment lengthenings (taking into account both the femoral and tibial gain in length). The ideal moment of compression was 5.6 N/cm(2). Acceleration of the bone repairing process was evidenced by activation of the osteotrop hormone system. According to the SOFCOT classification of complications (1990), 60 patients (76.9%) were in category I, 15 (19.3%) in category II, and 3 (3.8%) in category III. DISCUSSION: Improvement of lengthening procedures with external fixators remains an important issue. Treatment periods are often long with consolidation indices for the femur ranging from 39.6 d/cm to 45 d/cm, which can lead to many types of complications. Use of a high-frequency progressive lengthening procedure based on the Ilizarov method considerably reduces the rate of complications compared with progressive lengthening methods and has allowed achieving more satisfactory results in a shorter treatment period. CONCLUSION: Multiple-segment lengthening using an automatic lengthening procedure set at 1 mm per day in four times provides an important reduction in the treatment delays since distraction is performed more rapidly and fewer steps are needed. Automatic high-frequency lengthening with the Ilizarov method provides optimal conditions for tissue regeneration: Treatment periods are shorter and anatomic and functional outcome is very satisfactory. Stimulation by extemporaneous compression of the regeneration zone allows a significant reduction in the duration of consolidation. Shorter delays to consolidation help avoid device-related complications.

Adolescent↗
PubMed1996

The forces which develop in the tissues during leg lengthening. A clinical study.

Axial forces were measured during limb lengthening in a series of ten patients with varying pathologies in order to assess the mechanical characteristics of the distracted tissues and the levels of axial force to which soft tissues are subjected during leg lengthening. The pattern of force was found to vary according to the underlying pathology. For post-traumatic shortening in adults both the peak and the resting forces rose steadily during lengthening reaching maximum forces of the order of 300 N. Patients with congenitally short limbs developed very high peak forces (in some cases over 1000 N) and also showed large amounts of force relaxation (typically 400 to 500 N). When very high levels of force were recorded, there was a higher complication rate. In particular, there was a high instance of angular deformity. This occurred because the loads encountered resulted in failure of some of the external fixation frames.

Adult↗
PubMed1986

External fixator in management of fractures and leg lengthening.

The authors review the fundamental scientific factors that govern the healing of bone and conclude that they form a physiologic basis for the preferred use of external fixation in the management of fractures of the long bones as well as in the management of leg lengthening.

Bone Lengthening↗
PubMedDate not supplied

Dual-energy x-ray absorptiometry and force-plate analysis of gait in dogs with healed femora after leg-lengthening plate fixation.

Dual-energy x-ray absorptiometry was used to measure bone mineral density of four regions in healed femora of nine dogs after fracture fixation with a leg-lengthening plate. Six to 85 months (mean, 46 months) after surgery, the bone mineral density of healed femora was not significantly different from the contralateral uninjured femora (P > .05; power = 0.8 at delta = 15%). Radiolucencies around the proximal screws, apparently associated with screw loosening, were seen on radiographic views of the healed femora of three dogs. In one of these dogs, one screw in the proximal metaphysis had broken. Force-plate analysis of gait was also performed on dogs at the time of bone mineral density measurement. Peak vertical force was decreased in the pelvic limb with the healed fracture compared with the contralateral unoperated limb (P < 0.05). Clinically apparent lameness in three dogs did not appear to be associated with altered bone mineral density and may have been caused by hip osteoarthritis, a nondisplaced hairline diaphyseal fracture, and screw loosening in conjunction with extensive post-traumatic soft tissue injury.

Absorptiometry, Photon↗