Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “LEG LENGTHENING”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 73 records · Page 4Linked to original sources
PubMed1999

Nerve palsy after leg lengthening in total replacement arthroplasty for developmental dysplasia of the hip.

We reviewed 508 consecutive total hip replacements in 370 patients with old developmental dysplasia of the hip, to relate the amount of leg lengthening to the incidence of nerve palsies after operation. There were eight nerve palsies (two femoral, six sciatic), two complete and six incomplete. We found no statistical correlation between the amount of lengthening and the incidence of nerve damage (p = 0.47), but in seven of the eight hips, the surgeon had rated the intervention as difficult because of previous surgery, severe deformity, a defect of the acetabular roof, or considerable flexion deformity. The correlation between difficulty and nerve palsy was significant (p = 0.041). We conclude that nerve injury is most commonly caused by direct or indirect mechanical trauma and not by limb lengthening on its own.

Adult↗
PubMedDate not supplied

Leg lengthening and bone transport in children.

It is now possible to reliably lengthen limbs for inequality or short stature by distraction osteogenesis using external fixators. Similar techniques offer new methods of treating infected fractures and non-unions and correcting soft tissue contractures and bony deformities. This article outlines the techniques and indications for leg lengthening and bone transport.

Bone Lengthening↗
PubMed1999

[Behavior of soft tissue structures in surgical leg lengthening].

Experimental animal studies and clinical investigations show three processes going on during extremity lengthening with the Ilizarov-method. At first degenerative changes including cell necroses in the muscles, the nerves and the tendons [corrected] occur as well as denervation of muscle fibers resulting in neurogenous muscle atrophies. These alterations are followed by reperative and regenerative processes as well as the reinnervation of the denervated muscle fibers. Secondly histoneogenesis occur which leads to a high increase of tissue-specific cells and a growth of the muscles, tendons and vessels. Therefore tensile-stress is an important factor of tissue growth. Thirdly adaptive processes proceed during leg lengthening. For example the high biosynthetic activity during tissue growth seems to indicate an increase of vasa vasorum.

Animals↗
PubMed1984

Treatment of femoral shaft fractures in the spinal cord injury patient using the Wagner leg lengthening device.

External skeletal fixation for the treatment of femoral shaft fractures in the spinal cord injury patient is simple to apply, provides good fracture immobilization, affords easy access to the limb for skin care, and permits significant patient mobility and early return to pre-fracture functional status. This paper presents the rationale for the use of, and the technique of application of, the Wagner leg lengthening device for the external skeletal fixation of femoral shaft fractures in the SCI patient.

Femoral Fractures↗
PubMed1999

Acceleration of increase in bone mineral content by low-intensity ultrasound energy in leg lengthening.

The effect of ultrasound energy on bone has been studied for a long time. In particular, multiple effects of low-intensity ultrasound energy have recently been demonstrated experimentally, such as increases in bending strength of fracture callus, acceleration of soft callus formation and endochondral ossification of the callus at the fracture site, stimulation of aggrecan gene expression, or modulation of TGF-beta synthesis and increase of calcium uptake. Clinically, prospective, randomized, and double-blind trials showed the efficacy of low-intensity ultrasound beam stimulation in the acceleration of fracture healing, with a significant decrease in the time to healing. On the other hand, callotasis, a popular method for bone lengthening, requires much time for new bone formation, and an external fixator must be remain on the patient for a long period. This is one of the major problems of the callotasis technique. If ultrasound energy stimulation could accelerate the rate of callus formation in callotasis, the external fixator could be removed earlier, the treatment period could be shortened, and the patient could return to daily activities more quickly. We report on the use low-intensity ultrasound beam stimulation during leg lengthening with the callotasis method in which callus formation was poor.

Adult↗
PubMed1994

Postoperative sciatic and femoral nerve palsy with reference to leg lengthening and medialization/lateralization of the hip joint following total hip arthroplasty.

The radiographs and prospective records of 1284 (1152 primary and 135 revisions) Charnley low friction arthroplasties performed by one surgeon were studied in reference to postoperative elongation of the limb and lateralization or medialization of the center of rotation of the hip joint and their effect on postoperative nerve palsy. Displacement of the center of the hip joint in relation to fixed points on the pelvis was measured. In primary low friction arthroplasties, leg lengthening ranged from 0.4 to 4 cm; in the revision group, they ranged from 0.04 to 5.8 cm. Sixty-six hips were lengthened more than 2 cm. The center of rotation of the hip was lateralized in 18.1% of cases and medialized in 61.9%. A single case of postoperative sciatic nerve palsy (the result of laceration of the sciatic nerve at surgery) was identified. These study results indicate that nerve injuries after total hip arthroplasty may be caused by local insult, and may not be related to elongation of the limb or postoperative alteration of the center of rotation of the hip.

Adolescent↗
PubMed1994

Distraction effects on muscle. Leg lengthening studied in rabbits.

We investigated changes in the anterior tibial muscle during lengthening of the lower leg in rabbits. In 37 rabbits, an osteotomy of the right middle tibia was performed and was fixed by a unilateral external fixator. The rabbits were randomized into 6 groups. In groups 1, 2, and 3 the tibiae were distracted 0.5 mm/day. In groups 1 and 2, the rabbits were killed after 14 and 28 days of distraction, respectively, and in group 3 after 28 days of distraction, followed by 14 days of rest. Groups 1a, 2a, and 3a served as controls. They were treated similarly as groups 1, 2, and 3, but no distraction was performed. Proliferating cell nuclei were labeled with 5-bromo-2-deoxyuridine and were identified by immunohistochemical staining. The weight of the muscle was measured. During bone lengthening the muscle showed signs of growth, as indicated by increasing weight and number of proliferating cell nuclei. This was observed only during lengthening and it ceased when the lengthening was stopped.

Animals↗
PubMed1976

Leg lengthening.

Explore the source record for details and available documents.

Adolescent↗
PubMed1991

[A trial of ultrasonographic use for evaluating leg lengthening].

Modified de Bastiani method of callotasis with Wagner apparatus was used as a lengthening procedure of 4 femurs and 1 tibia. The ultrasonography was applied to measure the degree of distraction, to determine the eventual axial deviation of the bone ends and to follow up the callus formation in the gap. The obtained results were compared with radiography.

Bone Lengthening↗
PubMed1995

[Good results but many complications in unilateral leg lengthening techniques].

OBJECTIVE: Assessment of the results and complications of limb lengthenings according to Wagner and De Bastiani. DESIGN: Retrospective. SETTING: University Hospital Groningen, the Netherlands. METHODS: Between 1978 and 1993, 10 Wagner and 23 De Bastiani limb lengthenings were performed on 16 patients with leg length discrepancy and 3 patients with short stature. The lengthening procedures were assessed for mean lengthening, healing index (treatment days per centimeter of lengthening) and complications. The residual length discrepancy was measured indirectly. Total gain in body height was measured in the short stature patients. RESULTS: For the Wagner upper leg procedures the mean lengthening was 40 mm and the healing index 81 days/cm. For the lower leg these were 37 mm and 81 days/cm respectively, for the Bastiani lengthenings because of length discrepancy the figures were 70 mm and 46 days/cm (upper leg) and 53 mm and 52 days/cm (lower leg), and for short stature 74 mm and 46 days/cm (upper leg) and 57 mm and 55 days/cm (lower leg). There were 37 complications. Lengthening in 6 Wagner and 3 De Bastiani procedures was interrupted because of several of these complications. In 9 patients with length discrepancy the final result was satisfactory, 3 patients were not yet fully grown. Four patients had a residual length discrepancy of 2.5 to 3.5 cm. The short stature patients gained an average of 13.1 cm in height. CONCLUSION: Limb lengthenings are accompanied by many complications and patients should be monitored intensively, but the results are usually good.

Adolescent↗
PubMedDate not supplied

Behavior of blood vessels during lower-leg lengthening using the Ilizarov method.

Using a ring fixator, lengthening of the right lower leg by 2.5 cm at a distraction rate of 2 x 0.5 mm per day was performed in 24 beagle dogs. After a postoperative latency period of 5 days and a distraction phase of 25 days, half the dogs were killed (30-day group). The remaining half were killed after a second interval of 25 days (55-day group). After the experiment, the anterior tibialis artery and vein with their supporting vessels, as well as the lesser saphenous vein of both the lengthened right side and the control side were excised and examined histologically, histomorphometrically, and electron microcopically. No morphologic changes of the vascular walls and no increase of collagenous or elastic fibers could be found. The histomorphometric evaluations showed a significant increase in the number of vasa vasorum in the dogs of both the 30- and 55-day groups. No significant difference in thickness of the vascular wall, tunica media, and adventitia could be observed between the lengthened and the control side in both dog groups. It seems that blood vessels can adapt to continuous tension during callus distraction without suffering structural damage and are the least limiting factor concerning distraction speed, distraction rhythm, and distraction length during callus distraction.

Animals↗
PubMed1990

Force and stiffness changes during Ilizarov leg lengthening.

Biomechanical considerations of limb lengthening procedures are fundamental to their clinical outcome. The purpose of this study was to determine the relationships among force, stiffness, and distracted length in a patient whose leg was lengthened 50 mm with the Ilizarov procedure. A modified Ilizarov apparatus with force transducers in its three columns was surgically applied to the left tibia of an 11-year-old female patient after corticotomy of the proximal metaphysis. The leg was distracted 0.25 mm four times daily for 50 days, commencing six days after surgery. At approximately weekly intervals, forces at rest were recorded before and after distraction. Resting predistractional force magnitudes increased almost linearly during the first three weeks of lengthening, from 49 N to 223 N. The rate of increase slowed markedly thereafter with a further force increase of 11 N in the next three weeks. The stiffness of the limb, derived from the change in force accompanying the 0.25-mm change in length, increased by approximately 3.9%/mm of distracted length with 95% confidence limits of 6.8% and 0.9%. These results show marked differences from the nonlinearly increasing force-displacement relationship during in vitro limb distraction.

Biomechanical Phenomena↗
PubMed1997

[Leg-lengthening for length inequality].

32 patients (age range 1.5-22 years) were treated for leg-length discrepancy. 39 lengthening procedures were performed of which 36 involved gradual distraction, in 2 cases chondrodiasthesis was used, and 1 had 1-step elongation. Gradual distraction was done according to Ilizarov, including corticotomy and a 1-week delay before the initiation of distraction. In 33 cases Wagner's external fixator was used, in 2 Ilizarov frame and in 1 an orthofix fixator. There was complete clinical and radiologic union in all but 1 case. Significant correction of leg-length discrepancy and equalization of leg-length was achieved in most patients. In some growing patients over-correction was successfully achieved. The most prevalent complications were pin-site problems, axis deviation, joint subluxation and joint contractures. At latest follow-up most of these complications had disappeared. 91% of the patients either functioned normal or were only mildly limited.

Adolescent↗