Regenerate bone fracture rate following femoral lengthening in paediatric patients

被引:7
作者
Burke, N. G. [1 ]
Cassar-Gheiti, A. J. [1 ]
Tan, J. [1 ]
McHugh, G. [1 ]
O'Neil, B. J. [1 ]
Noonan, M. [1 ]
Moore, D. [1 ]
机构
[1] Our Ladys Childrens Hosp Crumlin, Dept Orthopaed Surg, Dublin, Ireland
关键词
regenerate fracture; circular external fixator; distraction osteogenesis; femoral lengthening; CONGENITAL SHORT FEMUR; LOWER-LIMB; DISTRACTION; COMPLICATIONS; OSTEOGENESIS; CHILDREN; WAGNER;
D O I
10.1302/1863-2548.11.160216
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Purpose Femoral lengthening using a circular or mono-lateral frame is a commonly used technique. Fracture at the site of the regenerate bone is a major concern especially following removal of the external fixator. This aim of this study was to assess the rate of fracture of the regenerate bone in this single surgeon series of paediatric patients and determine potential risk factors. Methods Retrospective review of all the femoral lengthening performed by the senior author was performed. The medical and physiotherapy notes were reviewed. The gender, age at time of surgery, disease aetiology, total days in the external fixator and length of the new regenerate bone were recorded. Patients who sustained a regenerate fracture were identified. Results A total of 176 femoral lengthening procedures were performed on 108 patients. Eight regenerate fractures occurred in seven patients (4.5%). The mechanism of injury was a fall in five cases and during physiotherapy in three cases. The regenerate fracture occurred a median number of nine days following removal of frame. There was no significant difference between gender, age at time of surgery, total time in external fixator between those who sustained a regenerate fracture and those patients who did not. A significant difference was noted between the amount of lengthening between the 'regenerate fracture group' and the 'no fracture group' (50 mm vs 38 mm, respectively; p = 0.029). There was no association between disease aetiology and risk of regenerate fracture. Conclusions Femoral lengthening of more than 50 mm increases the risk of a fracture at the regenerate site regardless of the disease aetiology. We recommend avoidance of aggressive physiotherapy for the initial four weeks following external fixator removal.
引用
收藏
页码:210 / 215
页数:6
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