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SA Orthopaedic Journal

versão On-line ISSN 2309-8309
versão impressa ISSN 1681-150X

SA orthop. j. vol.8 no.4 Pretoria Jan. 2009




Simultaneous ipsilateral femur and tibia lengthening after an iatrogenic nerve injury: Shortening external fixator time



FF Birkholtz

MBChB(Pret), MMed(Orth)(Pret), FCOrth(SA; Netcare Unitas, Zuid Afrikaans and Steve Biko Academic Hospitals, Pretoria, South Africa





Limb lengthening using distraction osteogenesis is an established technique; however it is often limited by prolonged external fixation times, with their associated difficulties and complications. A case is presented where a leg lengthening was performed with a relatively short external fixation time. This was made possible by the equal distribution of the patient's leg length discrepancy between the femur and tibia, secondary to an iatrogenic nerve injury while the patient was still growing. The technique of simultaneous ipsilateral femoral and tibial lengthening was shown to be an effective method of shortening external fixator time in this case and opens the door for further application of this technique in other clinical scenarios.



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1. Aronson J. Limb-lengthening, skeletal reconstruction, and bone transport with the Ilizarov method. J Bone Joint Surg Am Aug 1997;79(8):1243-58.         [ Links ]

2. Friend L, Widmann RF. Advances in management of limb length discrepancy and lower limb deformity. Curr Opin Pediatr Feb 2008;20(1):46-51.         [ Links ]

3. Noonan KJ, Leyes M, Forriol F, Canadell J. Distraction osteogenesis of the lower extremity with use of monolateral external fixation. A study of two hundred and sixty-one femora and tibiae. J Bone Joint Surg Am Jun 1998;80(6):793-806.         [ Links ]

4. Simpson AH, Shalaby H, Keenan G. Femoral lengthening with the Intramedullary Skeletal Kinetic Distractor. J Bone Joint Surg Br Jul 2009;91(7):955-61.         [ Links ]

5. Hankemeier S, Gosling T, Pape HC, Wiebking U, Krettek C. Limb lengthening with the Intramedullary Skeletal Kinetic Distractor (ISKD). Oper Orthop Traumatol Feb 2005;17(1):79-101.         [ Links ]

6. Aston WJ, Calder PR, Baker D, Hartley J, Hill RA. Lengthening of the congenital short femur using the Ilizarov technique: a single-surgeon series. J Bone Joint Surg Br Jul 2009;91(7):962-7.         [ Links ]

7. Stanitski DF, Shahcheraghi H, Nicker DA, Armstrong PF. Results of tibial lengthening with the Ilizarov technique. J Pediatr Orthop Mar-Apr 1996;16(2):168-72.         [ Links ]

8. Curran AR, Kuo KN, Lubicky JP. Simultaneous ipsilateral femoral and tibial lengthening with the Ilizarov method. J Pediatr Orthop May-Jun 1999;19(3):386-90.         [ Links ]

9. Krieg AH, Speth BM, Foster BK. Leg lengthening with a motorized nail in adolescents : an alternative to external fixators? Clin Orthop Relat Res Jan 2008;466(1):189-97.         [ Links ]

10. Singh S, Lahiri A, Iqbal M. The results of limb lengthening by callus distraction using an extending intramedullary nail (Fitbone) in non-traumatic disorders. J Bone Joint Surg Br Jul 2006;88(7):938-42.         [ Links ]

11. Guichet JM, Deromedis B, Donnan LT, Peretti G, Lascombes P, Bado F. Gradual femoral lengthening with the Albizzia intramedullary nail. J Bone Joint Surg Am May 2003;85-A(5):838-48.         [ Links ]

12. Glorion C, Pouliquen JC, Langlais J, Ceolin JL, Kassis B. Femoral lengthening using the callotasis method: study of the complications in a series of 70 cases in children and adolescents. J Pediatr Orthop Mar-Apr 1996;16(2):161-7.         [ Links ]

13. Vargas Barreto B, Caton J, Merabet Z, Panisset JC, Pracros JP. Complications of Ilizarov leg lengthening: a comparative study between patients with leg length discrepancy and short stature. Int Orthop Oct 2007;31(5):587-91.         [ Links ]

14. Sakurakichi K, Tsuchiya H, Uehara K, Kabata T, Tomita K. The relationship between distraction length and treatment indices during distraction osteogenesis. J Orthop Sci 2002;7(3):298-303.         [ Links ]

15. Kristiansen LP, Steen H, Reikeras O. No difference in tibial lengthening index by use of Taylor spatial frame or Ilizarov external fixator. Acta Orthop Oct 2006;77(5):772-7.         [ Links ]

16. Antoci V, Ono CM, Antoci V, Jr., Raney EM. Pin-tract infection during limb lengthening using external fixation. Am J Orthop Sep 2008;37(9):E150-4.         [ Links ]

17. Maffulli N, Nele U, Matarazzo L. Changes in knee motion following femoral and tibial lengthening using the Ilizarov apparatus: a cohort study. J Orthop Sci 2001;6(4):333-8.         [ Links ]

18. Pandian JD, Bose S, Daniel V, Singh Y, Abraham AP. Nerve injuries following intramuscular injections: a clinical and neurophysiological study from Northwest India. J Peripher Nerv Syst Jun 2006;11(2):165-71.         [ Links ]



Dr FF Birkholtz
PO Box 11328
South Africa
Tel:+27(0)12 644-2641; Fax:+27(0)12 644-2642



No benefits of any form have been received from a commercial party related directly or indirectly to the subject of this article. Written informed consent was obtained from the patient to use his information and X-rays for the purposes of this article.

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