Effect of distraction osteogenesis in patient with tibial shortening after initial union of congenital pseudarthrosis of the tibia (CPT)
Journal Title: International Journal of Orthopaedics Sciences - Year 2018, Vol 4, Issue 3
Abstract
Background: This is a Retrospective study which was conducted with the purpose of evaluating the preliminary result of distraction osteogenesis in patients with tibial shortening after initial union of Congenital Pseudarthrosis of the Tibia (CPT). Methods: Identification of all the CPT cases with tibial shortening after initial union managed by proximal tibia lengthening using Ilizarov technique was done. All the patients charts and radiograms were reviewed. Results: 11 CPT cases were included between March 2013 and January 2018 with an average follow up of 41 months (range, 34-51 months). 8.5 years was the mean age at surgery. The average length of discrepancy was 5.6 cm (range, 2.0-8.2 cm). Radiological findings of proximal tibial dysplasia were found in eight cases while three other cases had no radiological findings. The average distraction length gained was 5.3cm (range, 3.5 -8.0 cm) with a mean elongation rate of 21.4% (range, 15-30%). The Healing Index (HI) was 63.1 d/cm (range, 47–77 d/cm). The Findings seen in the eight patients with proximal tibial dysplasia was that out of eight cases, five cases had lateral callus, three had central callus and poor bone regeneration was seen in all of them. In the three patients who had no radiological findings concave shaped callus was identified with an average HI of 52.7 d/cm. None of the patients had refracture, non-union, axis deviation or angulation of the distraction area. Two of the patients were found to have ankle stiffness. There was no evidence of knee contracture in any of the patients. There were five cases with pin tract infection which was managed by regular dressing and oral antibiotics. Conclusions: We concluded that proximal tibial lengthening after initial union of CPT was effective for management of tibial shortening, however poor bone regeneration with various types of callus from normal, greater healing index and prolonged fixator wearing was seen. We recommended that when the limb length discrepancy (LLD) was more than 4 cm in younger children after primary union of CPT, tibia lengthening could be considered.
Authors and Affiliations
Mukesh Phalak, Nitin Wadhwa, Clevio Desouza, Shiju George
Keywords
Related Articles
- EP ID EP487674
- DOI 10.22271/ortho.2018.v4.i3j.97
- Views 107
- Downloads 0
Comparing the effectiveness of intra articular hyaluronic acid injection and intra articular corticosteroid injection in symptomatic osteoarthritis knee
Background: Osteoarthritis (OA) knee is a most common chronic degenerative condition effecting old age group individuals. Intraarticular (IA) injections is the final non-operative modality and includes corticosteroids, v...
Functional outcomes of conservative management in rotator cuff tendinitis in a teritiary hospital in south India
Background: Tendinitis of the rotator cuff and the shoulder impingement are considered to be common intrinsic causes of shoulder pain and disability. They are characterized by pain and painful arc of abduction and signs...
Study of microbilogical flora and role of primary bacterial cultures in management of open fractures of long bones
Background: Microbiology of open fracture wounds is constantly changing. A clear understanding of the bacterial flora that could be expected is needed in order to administer a rational and effective antibiotic treatment...
Effect of flexibility and implant density on curve correction in adolescent idiopathic scoliosis
Type of study: Retrospective study Objectives: To evaluate correlation between flexibility, implant density on curve correction in adolescent idiopathic scoliosis Materials and methods: We retrospectively reviewed all co...
A comparison of neurogenic claudication outcome score and oswestry disability index in degenerative lumbar spinal canal stenosis post decompression, posterior stabilization and fusion
Degenerative lumbar spinal canal stenosis (LSCS) is a narrowing of the spinal canal or intervertebral foramina secondary to degenerative changes. Current treatments focused mainly on improving the functional outcome and...