Lengthening and then nailing with hexapod fixators for tibial shortening deformity
Objective:To evaluate the safety and efficacy of lengthening and then nailing(LATN)with hexapod fixators in treating tibial shortening.Methods:We retrospectively analyzed clinical data from 10 patients with tibial shortening treated with LATN from April 2018 to September 2022.There were 6 males and 4 females,aged 17 to 33 years,with an average age of(23.5±6.2)years.The medial proximal tibial angel(MPTA)and the percentage of the mechanical axis passing through the tibial plateau were measured before and after the operation.At the final follow-up,treatment efficacy was evaluated using the JST tibial lengthening score,which is a modified version of the lengthening over nail(LON)score.Additionally,patient satisfaction was evaluated using a Likert scale.Spearman correlation analysis was used to analyze the correlations between postoperative parameters and age,expected length,and actual lengthening achieved.Results:All patients were followed up for 9 to 59 months,with an average of(35.2±12.8)months.The lengthening achieved was 2.0-10.6 cm,with an average of(6.2±2.3)cm.The duration of external fixation was 1.9-6.1 months,with an average of(4.7±1.2)months.The external fixation index(EFI)was 0.6-1.4 months/cm,and the median(interquartile range)was 0.71(0.67,1.00)months/cm.The bone healing time was 4.2-14.4 months,with an average of(8.6±2.8)months.The bone healing index(BHI)was 1.0-2.6 months/cm,with an average of(1.5±0.5)months/cm.At the last follow-up,the JST tibial lengthening score showed 7 cases as excellent,3 as good,and no fair or bad cases.Nine patients were very satisfied with the results and one patient was satisfied.There was a statistically significant decreases in ankle range of motion,with an average decrease of 9.0°±3.2°(P<0.05).No significant difference was observed in the MPTA or the percentage of the mechanical axis passing through the tibial plateau before and after surgery(all P>0.05).Correlation analysis showed that age was correlated with the BHI,and expected lengthening was correlated with the EFI.No cases of deep infection were found.Conclusions:The LATN technique is a safe and effective method for achieving significant tibial lengthening.
Ilizarov TechniqueLengthening and then NailingHexapod FixatorTibia
万方数据
维普
