Gradual bilateral genu varum correction in skeletal dysplasia using the Ilizarov method

Seung Ju Kim, Balace Cielo, Sang Heon Song, Hae Ryong Song, Sang Yoon Song

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Options for lower limb realignment in skeletal dysplasia are acute versus gradual correction, internal versus external fixation, and external fixation with or without intramedullary nailing. The safety and versatility of the Ilizarov method in skeletal dysplasia patients makes it a procedure of choice. Materials and methods: We describe here our experience with this procedure with 48 skeletal dysplasia patients, with a mean age of 15 years, and a minimum follow-up of 2 years. Preoperative, postoperative, and latest follow-up measurements of tibia-femur (T-F) angle, conventional mechanical axis deviation (MAD-C), ground mechanical axis deviation (MAD-G), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), posterior distal femoral angle (PDFA), and posterior proximal tibial angle (PPTA) were compared. Results: The mean lengthening amount (LA) was 7.4 cm, mean lengthening percentage (LP) was 35.5%, mean external fixation index (EFI) was 28 days/cm, and mean healing index (HI) was 35 days/cm. Mean MAD-C and MAD-G correction were 9.3 mm and 11.8 mm, respectively. T-F angles, PPTA, MAD-C, and MAD-G were significantly improved. Equinus deformity was the most prominent obstacle, and varus recurrence was the most frequent sequela. Conclusion: In most skeletal dysplasia patients, lower limb realignment with gradual deformity correction using the Ilizarov method may be a reliable option. Equinus deformity occurs in those with more than 40% lengthening, but can be easily corrected. In addressing varus recurrence after gradual correction, the intrinsic and extrinsic factors should be sought first then treated accordingly.

Original languageEnglish
Pages (from-to)405-412
Number of pages8
JournalJournal of Orthopaedic Science
Volume16
Issue number4
DOIs
Publication statusPublished - 2011 Jul 1

Fingerprint

Genu Varum
Ilizarov Technique
Equinus Deformity
Thigh
Tibia
Femur
Lower Extremity
Intramedullary Fracture Fixation
Recurrence
Intrinsic Factor
mycophenolic adenine dinucleotide
Safety

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Gradual bilateral genu varum correction in skeletal dysplasia using the Ilizarov method. / Kim, Seung Ju; Cielo, Balace; Song, Sang Heon; Song, Hae Ryong; Song, Sang Yoon.

In: Journal of Orthopaedic Science, Vol. 16, No. 4, 01.07.2011, p. 405-412.

Research output: Contribution to journalArticle

Kim, Seung Ju ; Cielo, Balace ; Song, Sang Heon ; Song, Hae Ryong ; Song, Sang Yoon. / Gradual bilateral genu varum correction in skeletal dysplasia using the Ilizarov method. In: Journal of Orthopaedic Science. 2011 ; Vol. 16, No. 4. pp. 405-412.
@article{668691ca565645848565aacc2ce31c6e,
title = "Gradual bilateral genu varum correction in skeletal dysplasia using the Ilizarov method",
abstract = "Background: Options for lower limb realignment in skeletal dysplasia are acute versus gradual correction, internal versus external fixation, and external fixation with or without intramedullary nailing. The safety and versatility of the Ilizarov method in skeletal dysplasia patients makes it a procedure of choice. Materials and methods: We describe here our experience with this procedure with 48 skeletal dysplasia patients, with a mean age of 15 years, and a minimum follow-up of 2 years. Preoperative, postoperative, and latest follow-up measurements of tibia-femur (T-F) angle, conventional mechanical axis deviation (MAD-C), ground mechanical axis deviation (MAD-G), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), posterior distal femoral angle (PDFA), and posterior proximal tibial angle (PPTA) were compared. Results: The mean lengthening amount (LA) was 7.4 cm, mean lengthening percentage (LP) was 35.5{\%}, mean external fixation index (EFI) was 28 days/cm, and mean healing index (HI) was 35 days/cm. Mean MAD-C and MAD-G correction were 9.3 mm and 11.8 mm, respectively. T-F angles, PPTA, MAD-C, and MAD-G were significantly improved. Equinus deformity was the most prominent obstacle, and varus recurrence was the most frequent sequela. Conclusion: In most skeletal dysplasia patients, lower limb realignment with gradual deformity correction using the Ilizarov method may be a reliable option. Equinus deformity occurs in those with more than 40{\%} lengthening, but can be easily corrected. In addressing varus recurrence after gradual correction, the intrinsic and extrinsic factors should be sought first then treated accordingly.",
author = "Kim, {Seung Ju} and Balace Cielo and Song, {Sang Heon} and Song, {Hae Ryong} and Song, {Sang Yoon}",
year = "2011",
month = "7",
day = "1",
doi = "10.1007/s00776-011-0063-1",
language = "English",
volume = "16",
pages = "405--412",
journal = "Journal of Orthopaedic Science",
issn = "0949-2658",
publisher = "Springer Japan",
number = "4",

}

TY - JOUR

T1 - Gradual bilateral genu varum correction in skeletal dysplasia using the Ilizarov method

AU - Kim, Seung Ju

AU - Cielo, Balace

AU - Song, Sang Heon

AU - Song, Hae Ryong

AU - Song, Sang Yoon

PY - 2011/7/1

Y1 - 2011/7/1

N2 - Background: Options for lower limb realignment in skeletal dysplasia are acute versus gradual correction, internal versus external fixation, and external fixation with or without intramedullary nailing. The safety and versatility of the Ilizarov method in skeletal dysplasia patients makes it a procedure of choice. Materials and methods: We describe here our experience with this procedure with 48 skeletal dysplasia patients, with a mean age of 15 years, and a minimum follow-up of 2 years. Preoperative, postoperative, and latest follow-up measurements of tibia-femur (T-F) angle, conventional mechanical axis deviation (MAD-C), ground mechanical axis deviation (MAD-G), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), posterior distal femoral angle (PDFA), and posterior proximal tibial angle (PPTA) were compared. Results: The mean lengthening amount (LA) was 7.4 cm, mean lengthening percentage (LP) was 35.5%, mean external fixation index (EFI) was 28 days/cm, and mean healing index (HI) was 35 days/cm. Mean MAD-C and MAD-G correction were 9.3 mm and 11.8 mm, respectively. T-F angles, PPTA, MAD-C, and MAD-G were significantly improved. Equinus deformity was the most prominent obstacle, and varus recurrence was the most frequent sequela. Conclusion: In most skeletal dysplasia patients, lower limb realignment with gradual deformity correction using the Ilizarov method may be a reliable option. Equinus deformity occurs in those with more than 40% lengthening, but can be easily corrected. In addressing varus recurrence after gradual correction, the intrinsic and extrinsic factors should be sought first then treated accordingly.

AB - Background: Options for lower limb realignment in skeletal dysplasia are acute versus gradual correction, internal versus external fixation, and external fixation with or without intramedullary nailing. The safety and versatility of the Ilizarov method in skeletal dysplasia patients makes it a procedure of choice. Materials and methods: We describe here our experience with this procedure with 48 skeletal dysplasia patients, with a mean age of 15 years, and a minimum follow-up of 2 years. Preoperative, postoperative, and latest follow-up measurements of tibia-femur (T-F) angle, conventional mechanical axis deviation (MAD-C), ground mechanical axis deviation (MAD-G), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), posterior distal femoral angle (PDFA), and posterior proximal tibial angle (PPTA) were compared. Results: The mean lengthening amount (LA) was 7.4 cm, mean lengthening percentage (LP) was 35.5%, mean external fixation index (EFI) was 28 days/cm, and mean healing index (HI) was 35 days/cm. Mean MAD-C and MAD-G correction were 9.3 mm and 11.8 mm, respectively. T-F angles, PPTA, MAD-C, and MAD-G were significantly improved. Equinus deformity was the most prominent obstacle, and varus recurrence was the most frequent sequela. Conclusion: In most skeletal dysplasia patients, lower limb realignment with gradual deformity correction using the Ilizarov method may be a reliable option. Equinus deformity occurs in those with more than 40% lengthening, but can be easily corrected. In addressing varus recurrence after gradual correction, the intrinsic and extrinsic factors should be sought first then treated accordingly.

UR - http://www.scopus.com/inward/record.url?scp=80052439271&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80052439271&partnerID=8YFLogxK

U2 - 10.1007/s00776-011-0063-1

DO - 10.1007/s00776-011-0063-1

M3 - Article

C2 - 21559959

AN - SCOPUS:80052439271

VL - 16

SP - 405

EP - 412

JO - Journal of Orthopaedic Science

JF - Journal of Orthopaedic Science

SN - 0949-2658

IS - 4

ER -