Objective To explore the clinical effect of plating after lengthening to assist the consolidation of tibial short-ening deformity in children.Methods A retrospective analysis was conducted on 10 children with tibial shortening who were treated with circular external fixator lengthening and replacement with plate-assisted internal fixation(study group)in the Depart-ment of Pediatric Orthopedics of Tianjin Hospital from November 2019 to October 2022,and 16 children who were treated by cir-cular external fixator only during the same period were enrolled as the external fixator group(control group).Among the 26 cases,there were 15 males and 11 females,10 left knees and 16 right knees.The average age at the time of surgery was 8.8±4.7 years(range 5.1-13.8 years).The gender,side,age at the time of surgery were compared between the two groups.The extension length,external fixator index,healing index,Kolcaba comfort scale score,knee and ankle joint range of motion,complications and average total hospitalization costs were recorded.Results There were no significant differences in gender,side,age at the time of surgery between the study group and control group.The extended lengths were 5.44±1.25 cm and 5.78±1.11 cm respectively without signif-icant difference(t=0.096,P=0.096).The external fixator index and healing index were 17.86±2.94 d/cm vs.50.97±7.03 d/cm and 40.94±6.63 d/cm vs.45.24±5.98 d/cm in study group and the control group with significant differences(t=13.299,P＜0.001;t=1.289,P=0.033).The Kolcaba comfort scale score of the children in the study group was higher than that of the control group,with significant difference(t=6.821,P=0.001).Comparing the range of motion of the knee and ankle joints between the two groups,there were no significant differences before surgery,at the end of extension surgery,and at the final follow-up.When the extension end was healed,the range of motion of the knee joint was137.89°±4.40° vs.114.09°±13.60° and ankle joint was 64.35°±5.50° vs.56.65°±8.86° in the study group and control group with significant difference(t=17.235,P＜0.001;t=7.821,P=0.002).In the study group,4 cases had pin tract infection,but no refracture occurred;in the control group,pin tract infection occurred in 13 cas-es,and refracture occurred in 2 cases after removal of the external fixator.The average total hospitalization cost of the study group was higher than that of the control group with significant difference(t=3.745,P=0.036).Conclusion The clinical effect of re-placing plate-assisted internal fixator during the mineralization period of tibial shortening in children is reliable,and can signifi-cantly shorten the time for using external fixator.It is beneficial to the healing of the extended end of the osteotomy and the func-tional recovery of the knee and ankle joints.Being more comfortable for children with fewer complications,it is applicable for chil-dren who need long-distance extension,multiple extensions with limited joint function,poor tolerance for external fixators and low treatment compliance.
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