Leg lengthening by distraction osteogenesis using the Ilizarov apparatus: a novel concept of tibia callus subsidence and its influencing factors |
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| Authors: | Ashok K Shyam Surya Udai Singh Hitesh N Modi Hae-Ryong Song Seok-Hyun Lee Hyonggin An |
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| Institution: | (1) Rare Disease Institute, Department of Orthopedics, Korea University Guro Hospital, #80 Guro-Dong, Guro-Gu, Seoul, South Korea, 152-703;(2) Department of Orthopedic Surgery, Dongguk University International Hospital, Ilsan, South Korea;(3) Department of Biostatistics, College of Medicine, Korea University, Anam Hospital, Seoul, South Korea; |
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| Abstract: | 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. |
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