Pediatric pain patterns during Ilizarov treatment of limb length discrepancy and angular deformity.

The Ilizarov method of gradual incremental distraction of long-bone deformities has provided dramatic functional improvement in children, but its cost in terms of pain may be high. The intensity of pain experienced and its progression with time was measured prospectively in 23 patients (age 11-20 years) by the Adolescent and Pediatric Pain Tool (APPT) and the Hospital for Sick Children (HSC) Pain Scale at four test intervals. These instruments were composed of visual analogue scales, body diagrams, and word lists. Results indicated high levels of pain extending over several months, in sharp contrast to the general orthopedic pain experience. The prolongation of pain throughout the entire correction and consolidation processes must be recognized to ensure appropriate management, particularly in the outpatient setting.