- 期刊
- OpenAccess
Femoral Lengthening Using Double Monolateral Uni-Bar Fixators for Children's Leg Length Discrepancy-A Preliminary Report
並列摘要
Introduction: Limb lengthening by distraction osteogenesis is a common orthopedic treatment for leg length discrepancy (LLD). A monolateral fixator is a low profile device used for femoral lengthening, however the medical insurance program in Taiwan does not reimburse the cost. Hence, a new double Uni-Bar fixator module for femoral lengthening was developed. Purpose: The purpose of this study was to review the results and complications of femoral lengthening using this new double rod module. Methods: A retrospective case series study included patients who underwent femoral lengthening using a double Uni-Bar fixator module. The module included half pins, pin clamps and two U5 extensible rods. The outcomes were evaluated by the amount of lengthening, lengthening rate by days per centimeter, and whether the discrepancy was reduced to less than 2 cm with a neutral mechanical axis of the lower extremities. Complications were assessed according to Donnan's classification. Results: Seven consecutive cases with eight femoral lengthening procedures were enrolled. The femur was lengthened by 31.9 mm in average (range: 16-41 mm) in 7.6 months (range: 4-12 months), and the rate of lengthening was 71.8 days/cm (range: 42.9-135 days/cm). With concomitant tibial lengthening in one case, LLD was reduced from -51 mm (range: -31- -86 mm) to -12 mm (range: +3- -20 mm). Nine complications including one Donnan grade 1, five grade 2, and two grade 3 occurred in four cases. Conclusion: A double Uni-Bar module is a treatment option that provides good stability and versatile adjustment through the two Uni-Bars. Our preliminary experience revealed comparable lengthening efficacy and complication rate to previous reports. The findings of this study provide evidence to support the use of a double Uni-Bar module, and this may provide an alternative method for orthopedic doctors to treat their patients with LLD.
延伸閱讀
- 張宇正、Tarek Abdalla EI-Gammal、林志鴻、魏福全（1995）。Double Struts Fibular Osteoseptocutaneous Flap in Segmental Femoral Defect Reconstruction。中華民國重建整形外科醫學會雜誌，4(4)，276-281。https://doi.org/10.7096/JPRSA.199512.0276
- Palatnik, Y., & Rozbruch, S. R. (2011). Femoral Reconstruction Using External Fixation. Advances in Orthopedics, 2011(), 162-171. https://doi.org/10.4061/2011/967186
- Su, Y. P., Wang, M. N., & Chang, W. N. (2007). Successful Treatment of Congenital Pseudarthrosis of the Tibia with Long Segment Fibular Allografting in a Young Child. Journal of the Formosan Medical Association, 106(3), 44-49. https://doi.org/10.29828/JFMA.200703.0010
- Chiang, C. H., Cheng, C. W., Shen, P. W., & Wu, D. Y. (2002). Periprosthetic Femoral Shaft Fracture in the Using Dall-Miles Cable and Plating System: 2 Years' Experience with 14 Cases. Journal of Orthopaedic Surgery Taiwan, 19(4), 193-198. https://www.airitilibrary.com/Article/Detail?DocID=10116923-200212-19-4-193-198-a
- Su, Y. P., Wang, M. N., & Chang, W. N. (2007). Successful Treatment of Congenital Pseudarthrosis of the Tibia with Long Segment Fibular Allografting in a Young Child. Journal of the Formosan Medical Association, 106(3_S), s44-s49. https://doi.org/10.29828/JFMA.200703.0034