Leg lengthening by distraction osteogenesis using the Ilizarov apparatus: A novel concept of tibia callus subsidence and its influencing factors

Ashok K. Shyam, Surya Udai Singh, Hitesh N. Modi, Hae Ryong Song, Seok Hyun Lee, Hyonggin An

Research output: Contribution to journalArticle

17 Citations (Scopus)


This article studies the incidence and magnitude of delayed callus subsidence, which will also help in study the hypothesis of three cortex corticalisation to determine the time of fixator removal during distraction osteogenesis (DO). Eighty-one tibia segments with mean lengthening of 7.7±2.9 cm were studied with age, gender, skeletal maturity, amount and percentage of lengthening, callus pattern, callus shape, number of cortices seen at the time of fixator removal, bone mineral density (BMD) ratio, and callus diameter ratio analysed for their effect on callus subsidence. All segments had tibia callus subsidence ranging from 4 mm to 3.2 cm with 54% having significant subsidence of more than 1 cm. Multivariate regression analysis revealed only the amount of lengthening and callus patterns to be significant. In conclusion, we can say that tibia callus subsidence is a significant delayed complication and factors affecting it can be used to determine the time of fixator removal.

Original languageEnglish
Pages (from-to)1753-1759
Number of pages7
JournalInternational Orthopaedics
Issue number6
Publication statusPublished - 2009 Dec 1


ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this