Tibial lengthening and concomitant foot deformity correction in 14 patients with permanent deformity after poliomyelitis

Song, Hae Ryong; Myrboh, Valencia; Oh, Chang Wug; Lee, Sung Tae; Lee, Suk Ha

doi:10.1080/00016470510030670

Cited by 25 publications

(24 citation statements)

References 23 publications

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“…Tibial lengthening procedures in poliomyelitis patients are associated with frequent complications. The most common complications recorded in such cases are delayed consolidation and recurrent equinus contracture of the ankle requiring additional lengthening of the Achilles tendon [10]. In our patients, we held the ankle in the proper position during lengthening using the Ilizarov frame (by a foot plate attached to the tibial frame) to avoid development of equinus deformity.…”

Section: Discussionmentioning

confidence: 99%

“…In all patients the lengthening was achieved, maintaining a residual 1-2 cm limb length inequality. This was part of the treatment plan to make it easier for the patient to clear his weak limb from the ground as recommended by many authors [5,10].…”

Section: Discussionmentioning

confidence: 99%

“…Studies have shown slow bone consolidation [10], the development of contractures during lengthening, and recurrence or progression of the existing deformities even after the lengthening phase has finished [5]. To decrease this high complication rate, many modifications have been described, including bone grafting [7,11], lengthening over a nail [2], early removal of external fixation and replacement by internal fixation [12], aggressive physical therapy, and stabilisation of joints above and below the lengthened bone [1].…”

Section: Introductionmentioning

confidence: 99%

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Functional outcome after lengthening with and without deformity correction in polio patients

Emara

Khames²

2007

International Orthopaedics (SICO

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Functional outcome after lengthening with and without deformity correction in polio patients

Emara

Khames²

2007

International Orthopaedics (SICO

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“…Our ROM values after GSR were better than those reported in other studies (Table 6). Schroeder [17] only had a 16°i ncrease in ankle dorsiflexion after endoscopic GSR while another study reported a 13°increase in dorsiflexion [19]. Additionally, DiDomenico et al [5] accomplished an 18°g ain in dorsiflexion after endoscopic GSR.…”

Section: Discussionmentioning

confidence: 99%

“…A literature search revealed a wide range of reported frequencies of ankle equinus with tibial lengthening. Studies report an incidence range from 10% to 50% depending on the etiology of shortening [1,19]. The resulting equinus contracture can lead to a disruption in ankle, foot, and gait function [7].…”

Section: Introductionmentioning

confidence: 99%

What Risk Factors Predict Usage of Gastrocsoleus Recession During Tibial Lengthening?

Rozbruch

Zonshayn

Muthusamy

et al. 2014

Clin Orthop Relat Res

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Background Tibial lengthening is frequently associated with gastrocsoleus contracture and some patients are treated surgically. However, the risk factors associated with gastrocsoleus contracture severe enough to warrant surgery during tibial lengthening and the consistency with which gastrocsoleus recession (GSR) results in a plantigrade foot in this setting have not been well defined. Questions/purposes We compared patients treated with or without GSR during tibial lengthening with respect to (1) clinical risk factors triggering GSR use, (2) ROM gains and patient-reported outcomes, and (3) complications after GSR. Methods Between 2002 and 2011, 95 patients underwent tibial lengthenings excluding those associated with bone loss; 82 (83%) were available for a minimum followup of 1 year. According to our clinical algorithm, we performed GSR when patients had equinus contractures of greater than 10°while lengthening or greater than 0°before or after lengthening. Forty-one patients underwent GSR and 41 did not. Univariate analysis was performed to assess independent associations between surgical characteristics and likelihood of undergoing GSR. A multivariate regression model and receiver operating characteristic curves were generated to adjust for confounders and to establish risk factors and any threshold for undergoing GSR. Chart review determined ROM, patient-reported outcomes, and complications. Results Amount and percentage of lengthening, age, and etiology were risk factors for GSR. Patients with lengthening of greater than 42 mm (odds ratio [OR]: 4.13; 95% CI: 1.82, 9.40; p = 0.001), lengthening of greater than 13% of lengthening (OR: 3.88; 95% CI: 1.66, 9.11; p = 0.001), and congenital etiology (OR: 1.90; 95% CI: 0.86, 4.15; p = 0.109) were more likely to undergo GSR. Adjusting for all other variables, increased amount lengthened (adjusted OR: 1.05; 95% CI: 1.02, 1.07; p \ 0.001) and age (adjusted OR: 1.02; 95% CI: 0.99, 1.05; p = 0.131) were associated with undergoing GSR. Patients gained 24°of ankle dorsiflexion after GSR. Selfreported functional outcomes were similar between patients with or without GSR. Complications included stretch injury to the posterior tibial nerve leading to temporary and partial loss of plantar sensation in two patients.

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Management of traumatic tibial defects using free vascularized fibula or Ilizarov bone transport: A comparative study

et al. 2008

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There are several options for the treatment of traumatic tibial defects. Among these options, free vascularized fibula and Ilizarov bone transport are well-known and effective techniques. The differences between both techniques and the indications for each of them are not well studied in the literature. Between September 1995 and December 2004, Ilizarov bone transport and free vascularized fibula were used to treat 25 traumatic bone. Patients were divided into two groups, Ilizarov group (12) and free fibula group (13). Preoperative data, operative data, duration of treatment, functional outcome, range of motion loss, number of secondary procedures, and type and rate of complications were compared in both groups. All the cases were ultimately united in both groups. Operative time and blood loss were significantly higher in the free fibula group. Although external fixation time was longer in the Ilizarov group, the overall duration of treatment was similar. Range of motion loss was less in the Ilizarov group, but the overall functional outcome was similar. There was no difference in complication rate, or number secondary procedures. Defect size was found to have the most significant effect on the results. Results were much better in the free fibula group when the defect length was 12 cm or more while the results were better in Ilizarov group when the defect length was less than 12 cm. We recommend using free vascularized fibula for traumatic tibial defects of 12 cm or more, whenever experience is available.

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Tibial lengthening and concomitant foot deformity correction in 14 patients with permanent deformity after poliomyelitis

Abstract: The gradual foot frame distraction method was associated with major complications, such as recurrent foot deformity, joint luxation, and arthritis. We therefore recommend triple arthrodesis as a concomitant procedure during tibial lengthening

Cited by 25 publications

References 23 publications

Functional outcome after lengthening with and without deformity correction in polio patients

Functional outcome after lengthening with and without deformity correction in polio patients

What Risk Factors Predict Usage of Gastrocsoleus Recession During Tibial Lengthening?

Management of traumatic tibial defects using free vascularized fibula or Ilizarov bone transport: A comparative study

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