Lengthening With External Fixation Is Effective in Congenital Femoral Deficiency

Abstract

Background Treatment of congenital femoral deficiency is a complex, multistage protocol and a variety of strategies have been devised to address joint instability, limb length inequality, and deformities. Despite being an important part of the algorithmic approach to the overall treatment of patients with congenital femoral deficiency, a reproducible, safe, and functional treatment for femoral length discrepancy in patients with mild and moderate congenital femoral deficiency has not been reported. Questions/purposes (1) Does femoral lengthening by means of distraction osteogenesis, using a monolateral external fixator, result in effective lengthening without loss of hip or knee range of motion? (2) Does femoral lengthening cause an inhibition of femoral growth in patients with congenital femoral deficiency? (3) Do patients/families report satisfactory functional and emotional outcomes after undergoing femoral lengthening? (4) (Schaumburg, IL, USA), Pega Medical, and Springer (New York, NY, USA) outside the submitted work. The institution of one or more of the authors (JEH, SCS, DP) has received, during the study period, funding from Smith & Nephew, DePuy Synthes, Orthofix, Biomet, and OrthoPediatrics. One or more of the authors certifies that he (SCS), or a member of his or her immediate family, has received or may receive payments or benefits, during the study period, an amount less than USD 10,000 from Smith & Nephew, an amount less than USD 10,000 from Ellipse Technologies, and an amount less than USD 10,000 from Orthofix. One or more of the authors certifies that he (DP), or a member of his or her immediate family, has received or may receive payments or benefits, during the study period, an amount of USD 100,001 to USD 1,000,000 from Orthofix, Inc during the period of this study. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Clinical Orthopaedics and Related Research 1 neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA approval status, of any drug or device before clinical use. Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained. 123Clin Orthop Relat Res (2015) 473:3261-3271 DOI 10.1007 Clinical Orthopaedics and Related Research ® A Publication of The Association of Bone and Joint Surgeons® 1a, 1b, or 2a that had not previously undergone lengthening and had stable hip and knee joints. Of the 32 patients that completed treatment, 30 (94%) were available at a minimum of 2 years (mean, 3 years; range, 2-4.5 years) and were evaluated in this retrospective study. Preoperative and postoperative radiographic analysis, physiotherapy data, patient-based outcomes s...

The knee in congenital femoral deficiency and its implication in limb lengthening: a systematic review

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