Correction of juxtaarticular deformities in children using the Ilizarov apparatus.

BACKGROUND: Deformity correction using external fixation was performed for various disorders in children. We reviewed 18 children who underwent juxtaarticular deformity correction using the Ilizarov apparatus with either a transverse or focal dome osteotomy. The amount of deformity correction, external fixation time, external fixation index, length gained, and incidence of complications were examined.
METHODS: A series of 27 operations were performed in lower limb segments on 10 femurs and 17 tibias in 10 boys and 8 girls. The mean age at operation was 12 years (5-18 years). Deformity corrections were performed using a transverse osteotomy in 16 segments and a focal dome osteotomy in 11.
RESULTS: The average deformity corrected was 19 degrees (6 degrees-31 degrees). Acute correction was done in 14 segments and gradual correction in 13 segments. The mean lengthening was 4.2 cm in 12 segments (2-8 cm). The mean external fixation time was 161 days (78-352 days). In acute corrections, the external fixation time with a focal dome osteotomy (101 days) tended to be shorter than with a transverse osteotomy (142 days).
CONCLUSIONS: Accurate limb alignment was obtained for all cases. A focal dome osteotomy by maximizing the area of bony contact was more effective than a transverse osteotomy for acute deformity correction.