Background and purposeDistraction osteogenesis (DO) has been used to gain height in short statured individuals. However, there have been no studies comparing the clinical outcome of limb lengthening based on the etiology of the short stature. We assessed whether different underlying diagnoses are associated with varied clinical outcomes in these patients.MethodsWe performed a systematic review of the literature pertaining to lower limb lengthening using external fixation for short stature. Clinical outcomes including amount of lengthening, healing index (HI), and complications based on the underlying diagnosis for the short stature were documented.Results18 clinical studies were included, with 547 patients who underwent 1,581 lower limb segment lengthening procedures. Mean follow-up was 4.3 years. The average age at lengthening was less for individuals with achondroplasia/hypochondroplasia (A/H) (14.5 years) than for those with Turner’s syndrome (TS) (18.2 years) or with constitutional short stature (CSS) (21.7 years). Mean height gained was greater in patients with A/H (9.5 cm) than in those with TS (7.7 cm) or CSS (6.1 cm) group. The HI was better in A/H (30.8 days/cm) and CSS (32 days/cm) than in TS (45.1 days/cm). The reported complication rate per segment was lower for A/H (0.68) and TS (0.71) than for CSS (1.06).InterpretationPatients with A/H tolerated larger amounts of lengthening with fewer complications than those with other diagnoses.

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Impairment: International Cerebral Palsy Function and 3 Mobility Symposium, is a publication that compiled the 4 proceedings of international experts at an invitational 5 meeting in December 2019 in Banff, Canada supported 6 by Gillette Children's Foundation. It is a free download-7 able monograph recently published in 2020 by MacK-8 eith Press. The renowned contributors are comprised of 9 an interdisciplinary group of clinicians, basic scientists, 10 engineers and biomechanics specialists. The preface, 11 written by the editor Tom Novachek, states that the 12 goal is to stimulate the reader's "own scientific explo-13 ration." Unlike other books about cerebral palsy and 14 gait, this monograph does not shy away from including 21/05/2021; 8:27 File: prm-1-prm210029.tex; BOKCTP/xjm p. 2 2 W. Pierce / Book Review toxin injections can result in reduction of contractile 55 material and increased non-contractile material that was 56 still present 6 months later. This animal data may be 57 pertinent to decision making and as such should be 58 discussed with families and the team when present-59 ing treatment options. The monograph can serve as a 60 reference in preparation for answering those questions. 61 The monograph did achieve the goal of guiding my 62 own exploration to continue to examine my clinical 63 practice to ensure that I "first, do no harm" and be 64 open to changing my practice as more questions are 65 answered. After completing my own exploration, I in-66 tend to use this book primarily as an updated reference 67 which also provides direction in the continued search 68 for the optimal treatment for gait in individuals with 69 cerebral palsy. In the afterward, Dr.