Abstract
Patient's non acceptance of a bulky external fixator, the incidence of fractures of the regenerate, muscle transfixion giving rise to contractures especially in the Tendo Achilles, increased index of consolidation and the frequency of infections has made Limb lengthening with external fixators alone unpopular.
In a retrospective study, we evaluated the technique of limb lengthening over a sub muscular plate combined with Ilizarov external fixator as an alternative to external fixator alone and whether the combined procedure is successful in reducing the external fixator period. 15 patients (14 with length discrepancy in the lower limb and 1 with low stature) and a total of 16 limbs (15 tibiae and 1 femur) were lengthened over a sub muscular plate fixed on the proximal segment followed by corticotomy and application of external fixator. Lengthening was achieved at 1 mm/day followed by distal segment fixation with three or four screws on reaching the target length. The pre operative target length was successfully achieved in all patients at a mean of 4.4 cm (2.2 to 6.5 cm). The mean duration of external fixation was 59.2 days (33 to 107 days) with the mean external fixation index at 16.7 days/cm (10.95 to 23.78). Infection complicated the procedure in two patients and one patient had mild Tendo Achilles contracture. Lengthening over a plate drastically reduces the time external fixator needs to worn and is preferred by patients to limb lengthening over an external fixator alone. patient Lengthening over a plate provides an alternative method for limb lengthening, can be applied to children with open physes and to deformed bones.
[Lengthening over a Plate]
