Relationship between radiologic morphology of the bone lengthening formation and its complications

Citation
F. Forriol et al., Relationship between radiologic morphology of the bone lengthening formation and its complications, J PED ORT B, 8(4), 1999, pp. 292-298
Citations number
26
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Ortopedics, Rehabilitation & Sport Medicine
Journal title
JOURNAL OF PEDIATRIC ORTHOPAEDICS-PART B
ISSN journal
1060-152X → ACNP
Volume
8
Issue
4
Year of publication
1999
Pages
292 - 298
Database
ISI
SICI code
1060-152X(199910)8:4<292:RBRMOT>2.0.ZU;2-F
Abstract
The objective was to study the different types of lengthened bone regenerat ion and their development during the various phases of the process to corre late them with patient factors and the surgical technique used, and to esta blish a possible relation between the development of the bone lengthening f ormation and the problems or complications. The authors studied the radiogr aphs of a random group of 55 patients taken at three points during the cour se of treatment. The callus was classified with regard to its transverse di ameter and the presence or absence of hypodense areas. The overall callus t ype was significantly influenced by the etiology, the osteotomy site, and t he percentage lengthened. The percentage by which the limb was lengthened a t the beginning of the process influences the overall morphology of the cal lus. Poor callus had been lengthened the most, atrophic callus the least. T here was a correlation between the morphology of the overall callus at the end of treatment and the percentage lengthened, and between the percentage lengthened and the presence of bands at the end of treatment. The authors a lso found a significant correlation between age and the appearance of bands at the end of distraction. A central band was found among younger patients . The type of osteotomy affected the overall callus at the end of distracti on and at the end of treatment and also influenced the transverse diameter. All the elongations with poor bone formation at the end of treatment were found to have undergone a diaphyseal osteotomy. The most common complicatio n at the first follow-up and at the end of distraction was angulation. The diameter of the callus and the presence of bands at the end of treatment we re significantly related to the complications. Fracture occurred in the fir st 2 weeks after removal of the external fixator in 88% of cases and in the third and fourth week in the rest. However, the segment had no significant influence on the appearance of complications. Lengthened callus with incom plete trabecular formations and hypodense areas at the end of the treatment has a high risk of fracture at the end of treatment. Callus with axial dev iation, hypodense areas, or an insufficient transverse diameter during the lengthening procedure must be manipulated so that it reaches the maturing p hase in better condition.