Functional outcomes and complications of tibial lengthening using unilateral external fixation and then plating. A prospective case series

Nguyen, Luong V.; Le, Doan Van

doi:10.1016/j.amsu.2022.103262

Cited by 3 publications

(2 citation statements)

References 39 publications

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“…5,[7][8][9][10]24 Ankle equinus frequently accompanies tibial lengthening and is one of the most common complications. 31 Our study reveals a similar result with the most common problems being ankle equinus and pin tract infection.…”

Section: Effects Of Lengthening Frequency On Distraction Osteogenesis...supporting

confidence: 85%

Does The Lengthening Frequency Affect The Outcome of Distraction Osteogenesis? Comparing Two Times a Day with Four Times a Day Lengthening Protocol

Tangadulrat,

Adulkasem,

Wongcharoenwatana

et al. 2024

Siriraj Med J

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Objective: Distraction osteogenesis (DO) is a well-known technique. The traditional method utilized the lengthening frequency of four times a day (QID). Many mechanical factors may affect the DO outcome. However, the effect of distraction frequency has not been proven clinically. Therefore, we aim to investigate whether the BID and QID lengthening frequency affect the healing index and complications of the DO. Materials and Methods: We retrospectively reviewed patients who had undergone DO from 2010 – 2021. The patient was divided into BID and QID groups. Demographics, lengthening outcomes, and complications between the two groups were compared. We used the inverse probability of treatment weighting (IPTW) to determine the effect of treatment. Results: The median healing index (HI) of the patients whose lengthening was done QID is 41.36 (IQR 32.72 - 67.68) days/cm, and BID is 49.12 (IQR 35.28 - 62.54) days/cm, which did not differ significantly. The Odds ratio of achieving HI < 45 days/cm for patients receiving QID lengthening compare to BID is 1.12 (95% CI 0.31-3.99, p = 0.862 ). The IPTW did not show a difference in average treatment effects between QID and BID lengthening. The rates of minor and major complications were not significantly different between the two groups (26.1% in QID group and 32.1% in BID group). Conclusion: The frequency of QID and BID lengthening results in comparable HI and complications for patients who undergo DO. However, prospective research is needed to evaluate the effect of frequency differences in a clinical setting.

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Section: Effects Of Lengthening Frequency On Distraction Osteogenesis...supporting

confidence: 85%

Does The Lengthening Frequency Affect The Outcome of Distraction Osteogenesis? Comparing Two Times a Day with Four Times a Day Lengthening Protocol

Tangadulrat,

Adulkasem,

Wongcharoenwatana

et al. 2024

Siriraj Med J

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“…This is the first study regarding the use of a tether fixation of the proximal tibiofibular joint during tibial MILN lengthening, thus the discussion will focus on related literature addressing similar clinical scenarios. Numerous studies demonstrated distal migration of the fibular head during lengthening [ 7 – 14 ], with greater distance migrated consistently observed when the tibiofibular joint had no fixation [ 10 ]. However, Song et al [ 15 ] demonstrated that fibular migration could occur even if the joint is fixed with a tensioned wire.…”

Section: Discussionmentioning

confidence: 99%

Comparative fixation devices for preventing migration of the proximal tibiofibular joint during tibial lengthening: a tether versus screw fixation

et al. 2023

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Background When lengthening the tibia segment using motorized internal lengthening nails (MILN), undesired distal migration of the proximal fibula segment is prevented by tibiofibular stabilization, traditionally using a screw. A tightened cortical suspensory fixation rope (tether) is an alternative option, but its appropriateness has never been studied. The primary outcome was comparing the amount of proximal fibular migration between patients who were stabilized with either a tether or a screw. The secondary outcome was to evaluate the effect of fibular migration on the clinical outcome between both groups. Methods A retrospective study was conducted on patients who underwent tibial lengthening with MILN between April 2016 and June 2022. Two cohorts were compared: 18 limbs with tether fixation versus 29 limbs with screw fixation. Data on the patient's age, sex, etiologies, and clinical outcomes were collected. Radiographic measurements included the lengthening distance and the amount of proximal fibular migration. Results In total, 47 limbs from 41 patients, with average age 35.01 ± 13.72 years old. There were 28 males (68.29%) and 13 females (31.71%). The tether group demonstrated a statistically significant greater distance of migration than the screw group (p < 0.001), with an average migration distance of 8.39 ± 5.09 mm and 2.59 ± 3.06 mm, respectively. No correlation was found between the amount of tibial lengthening and the distance of proximal fibular migration in both the tether group (p = 0.96) and the screw group (p = 0.32). There was no significant difference in the change of knee extension between both groups (p = 0.3), and no patients reported knee pain or tightness. Conclusion A screw provides better resistance to proximal tibiofibular joint migration during MILN lengthening, but the difference appears clinically inconsequential. Either option appears suitable.

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Treatment of 18 cm lower limb length discrepancy using lengthening over nail technique in tibia and lengthening and plating in femur – A case report

Nguyen¹

2023

International Journal of Surgery Case Reports

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Functional outcomes and complications of tibial lengthening using unilateral external fixation and then plating. A prospective case series

Cited by 3 publications

References 39 publications

Does The Lengthening Frequency Affect The Outcome of Distraction Osteogenesis? Comparing Two Times a Day with Four Times a Day Lengthening Protocol

Does The Lengthening Frequency Affect The Outcome of Distraction Osteogenesis? Comparing Two Times a Day with Four Times a Day Lengthening Protocol

Comparative fixation devices for preventing migration of the proximal tibiofibular joint during tibial lengthening: a tether versus screw fixation

Treatment of 18 cm lower limb length discrepancy using lengthening over nail technique in tibia and lengthening and plating in femur – A case report

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