American Academy of Orthopaedic Surgeons 67th Annual Meeting Wednesday, March 15 to Sunday, March 19, 2000 Scientific Program

Limb lengthening by gradual elongation intramedullary nail (GEN or Albizzia )

Thursday, March 16, 2000
09:30 AM

Location: 314
Orange County Convention Center

Soo Bong Hahn, MD, Seoul, KOREA
Hui-Wan Park, MD, Seoul, KOREA
Hong Jun Park, MD, Seoul, KOREA

Leg length discrepancy or short stature is a significant problem to patients psychosocially and cosmetically. Recently, great progress in lower limb lengthening has been made by Ilizarov through distraction osteogenesis. However, an external fixator has some problems and complications as well as unsatisfactory cosmesis. Therefore, gradual elongation intramedullary nailing developed by Guichet, in 1986, has gained much attention for more stability and less discomfort. We reviewed 22 cases in 13 patients. The etiology of limb lengthening was as follows: familial short stature in 16 cases, Turner's dwarfism in 2 cases, leg length discrepancy due to the sequelae of poliomyelitis in 3 cases, and posttrauma in 1 case. The average age at the time of the operation was 23.8 years. The sites of lengthening were the femur in 7 cases and the tibia in 15 cases. The mean follow-up was 35.2 months. During the distraction period, 15 ratchetings per day (lengthening 1 mm/day) were performed. We evaluated the results with the lengthening index (LI) and the clinical and radiographic criteria. According to these criteria, there were sixteen excellent and six good results. There were no fair and poor results. In bilateral femoral lengthening, the average LI was 1.0 month/cm and there were no complications. In bilateral tibial lengthening, the average LI was 1.2 month/cm and there were few complications, which were resolved by secondary procedures. We suggest that the technique using the GEN is more stable, more comfortable and requires no longer lengthening time compared to an external fixator such as Ilizarov.

Pediatrics