Treatment of congenital long-bone deformities in children using the consequtive application of guided growth and external fixation: preliminary report

Abstract

Aim. This study aimed to estimate the results of congenital long bone deformities using the consecutive application of guided growth and external fixation.
 Materials and methods. We performed a retrospective analysis of the treatment results of 38 children with congenital deformities of long bones. Group 1 consisted of 17 children who underwent consecutive application of two methods: guided growth and external fixation. Group 2 (control group) consisted of 21 children who underwent isolated lengthening and deformity correction by external fixation.
 Results. There were 14 complications in group 1 and 25 complications in group 2. Moreover, only seven cases in group 1 had complications requiring surgical treatment, whereas 17 cases in group 2 required operative treatment for complications. There was a relatively low level of refractures: zero cases in group 1 and three cases in group 2. The most common complication was a recurrence of deformity associated with the continuous growth of children: seven cases in group 1 and eight cases in group 2. However, no recurrence of the torsion component of deformity was observed in any group 1 cases, and repeated guided growth could be performed in the six cases of growing children.
 Conclusion. The consecutive use of external fixation and guided growth to treat congenital deformities of the lower limbs is a promising direction for pediatric orthopedics because it reduces the incidence of complications. The repeated use of guided growth, because of its minimal invasiveness, is the most effective solution for the recurrence of deformity in a growing child.

Biomedical Materials and Devices with Focus on Orthopaedic and Cardio-vascular Problems

“…Either intra-medular bone nails, including fixation with scews, are used or plates are placed outside of the leg, and connected with the bone using screws eventually with an outside fixation (osteo-synthesis). For intra-medular nails titanium or titanium alloys are used as material, whereas high-strength steels are used for external devices [17,19,20].…”

“…The present results indicate that consistent use of methods of trans-osseous osteo-synthesis and controlled growth in the treatment of congenital deformities of the lower extremities is a promising approach in paediatric orthopaedics. Repeated use of controlled growth owing to its low morbidity provides an effective solution for the problem of recurrent deformity in a growing child [19,20].…”