Chang-Wug Oh1, Joon-Woo Kim1, Seung-Gil Baek1, Hee-Soo Kyung1, Hyun-Joo Lee1. 1. Department of Orthopaedic Surgery, Kyungpook National University Hospital, 50, 2-Ga, Samdok, Chung-gu, Daegu, 700-721, Republic of Korea. E-mail address for J.-W. Kim: orthopedics@naver.com.
Abstract
INTRODUCTION: Limb-lengthening with a submuscular locking plate provides a good alternative for patients, especially children, in whom lengthening over an intramedullary nail would be difficult. STEP 1 EXTERNAL FIXATION FOR LENGTHENING WITH SUBMUSCULAR PLATING: The first operation is divided into two steps, submuscular plating and external fixation with corticotomy; due to the anatomical characteristics, the procedures differ in the tibia and femur. STEP 2 LENGTHENING: Start distraction at seven to ten days after surgery and continue until the target length is achieved. STEP 3 LOCKING OF THE DISTAL SEGMENT AND REMOVAL OF THE EXTERNAL FIXATOR: When the target length has been achieved, place screws into the distal segment through plate holes and remove the fixator. STEP 4 POSTOPERATIVE CARE: Start with partial weight-bearing, obtain a radiograph every four to eight weeks, and allow full weight-bearing with crutches when osseous consolidation is observed. RESULTS: We prospectively performed limb lengthening using an external fixator and a submuscular locking plate in ten patients16.IndicationsContraindicationsPitfalls & Challenges.
INTRODUCTION: Limb-lengthening with a submuscular locking plate provides a good alternative for patients, especially children, in whom lengthening over an intramedullary nail would be difficult. STEP 1 EXTERNAL FIXATION FOR LENGTHENING WITH SUBMUSCULAR PLATING: The first operation is divided into two steps, submuscular plating and external fixation with corticotomy; due to the anatomical characteristics, the procedures differ in the tibia and femur. STEP 2 LENGTHENING: Start distraction at seven to ten days after surgery and continue until the target length is achieved. STEP 3 LOCKING OF THE DISTAL SEGMENT AND REMOVAL OF THE EXTERNAL FIXATOR: When the target length has been achieved, place screws into the distal segment through plate holes and remove the fixator. STEP 4 POSTOPERATIVE CARE: Start with partial weight-bearing, obtain a radiograph every four to eight weeks, and allow full weight-bearing with crutches when osseous consolidation is observed. RESULTS: We prospectively performed limb lengthening using an external fixator and a submuscular locking plate in ten patients16.IndicationsContraindicationsPitfalls & Challenges.
Authors: Daniel Zarzycki; Maciej Tesiorowski; Maja Zarzycka; Wojciech Kacki; Barbara Jasiewicz Journal: J Pediatr Orthop Date: 2002 May-Jun Impact factor: 2.324
Authors: J Eric Gordon; Charles A Goldfarb; Scott J Luhmann; Deborah Lyons; Perry L Schoenecker Journal: J Bone Joint Surg Am Date: 2002-06 Impact factor: 5.284