Functional outcomes and complications of tibial lengthening using unilateral external fixation and then plating. A prospective case series

• Published in: Annals of medicine and surgery 2022-02, Vol.74, p.103262-103262, Article 103262
• Main Authors: Van Nguyen, Luong, Van Le, Doan
• Format: Article
• Language: English
• Subjects: Case Series; Distraction; External fixater; Lengthening then plating; Osteogenesis; Plate; Vietnam
• ISSN: 2049-0801; 2049-0801
• DOI: 10.1016/j.amsu.2022.103262

and Importance: The purpose of this study was to assess the functional outcomes and complications of tibial lengthening using unilateral external fixation and then plating. This was a prospective case series study that enrolled people of short stature or leg length discrepancy of more than 3 cm from January 2019 to January 2021. A total of 11 patients (one male and 10 females) were recruited for the study, including seven short statures and four patients with leg length discrepancies. The external fixaters in this study were Muller's frame or Nhan's frame. The average age of patients at the time of surgery was 25.89 years (range: 13–41 years). The study included 18 tibias that were lengthened and then plated. Average tibial lengthening was 6.89 ± 1.25 cm (21.87 ± 6.59%). The functional result was excellent in seven patients and good in four patients. Pin-track infection occurred in three tibias. There was one case of superficial infection. 12 legs (66.7%) developed ankle equinus after removing the external fixator. Four legs with severe equinus deformity were treated with percutaneous tendo-Achilles lengthening. Valgus deviation occurred in eight tibias. Peroneal nerve neuropraxia occurred in two legs during distraction. Distal migration of the fibula head occurred in four legs. Our study suggested that tibial lengthening using Nhan's external fixater or Muller frame then plating was safe and effective provided complications were looked for and kept in check. Equinus contracture, pin-site infection, and valgus alignment were the most common complications. Level IV, prospective case series study. •Patients with a narrow intramedullary cavity, joint contracture, pediatric patients are not suitable for LON or motorized nail.•Tibial lengthening using external fixater then plating was safe and effective provided complications were kept in check.•Equinus contracture, pin-site infection, and valgus alignment were the most common complications.•Tibial lengthening then plating should be widely employed in patients who were not suitable for limb lengthening over a nail.