Is the High Healing Index a Complication of Progressive Long Bone Lengthening? Observations from a Cohort of 178 Children Treated with Circular External Fixation for Lower Limb Length Discrepancy
The use of external fixators (EFs) for lower limb lengthening is common for treating lower limb length discrepancy (LLD) in children. The concern at present revolves around extended treatment times, with some suggesting a healing index (HI) > 45 days/cm as a major complication. The aim of this st...
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| Format: | Article |
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MDPI AG
2023-09-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/10/10/1586 |
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| author | Alessandro Depaoli Marina Magnani Agnese Casamenti Tosca Cerasoli Marco Ramella Grazia Chiara Menozzi Marina Mordenti Gino Rocca Giovanni Trisolino |
| author_facet | Alessandro Depaoli Marina Magnani Agnese Casamenti Tosca Cerasoli Marco Ramella Grazia Chiara Menozzi Marina Mordenti Gino Rocca Giovanni Trisolino |
| author_sort | Alessandro Depaoli |
| collection | DOAJ |
| description | The use of external fixators (EFs) for lower limb lengthening is common for treating lower limb length discrepancy (LLD) in children. The concern at present revolves around extended treatment times, with some suggesting a healing index (HI) > 45 days/cm as a major complication. The aim of this study is to assess the factors affecting bone healing and treatment duration in children who undergo limb lengthening for LLD using circular EFs. A total of 240 lengthening procedures on 178 children affected by congenital or acquired LLDs (mean age at surgery 13.8 ± 2.8 years) were retrospectively evaluated. Complications according to Lascombes’ classification and treatment duration factors were analyzed. Mean HI was 57 ± 25 days/cm for the femur and 55 ± 24 days/cm for the tibia, with an HI > 45 days/cm in 64% of the procedures. A total of 189 procedures (79%) reported complications; 85 had an HI > 45 days/cm as the sole complication. While reducing the frame time is crucial, revising the classifications is necessary to avoid the overestimation of complications. |
| first_indexed | 2024-03-10T21:20:25Z |
| format | Article |
| id | doaj.art-2c3030963aee426081ede380df93b682 |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-10T21:20:25Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-2c3030963aee426081ede380df93b6822023-11-19T16:04:11ZengMDPI AGChildren2227-90672023-09-011010158610.3390/children10101586Is the High Healing Index a Complication of Progressive Long Bone Lengthening? Observations from a Cohort of 178 Children Treated with Circular External Fixation for Lower Limb Length DiscrepancyAlessandro Depaoli0Marina Magnani1Agnese Casamenti2Tosca Cerasoli3Marco Ramella4Grazia Chiara Menozzi5Marina Mordenti6Gino Rocca7Giovanni Trisolino8Unit of Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, ItalyUnit of Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, ItalyUnit of Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, ItalyUnit of Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, ItalyUnit of Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, ItalyUnit of Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, ItalyUnit of Rare Skeletal Disorders, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, ItalyUnit of Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, ItalyUnit of Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, ItalyThe use of external fixators (EFs) for lower limb lengthening is common for treating lower limb length discrepancy (LLD) in children. The concern at present revolves around extended treatment times, with some suggesting a healing index (HI) > 45 days/cm as a major complication. The aim of this study is to assess the factors affecting bone healing and treatment duration in children who undergo limb lengthening for LLD using circular EFs. A total of 240 lengthening procedures on 178 children affected by congenital or acquired LLDs (mean age at surgery 13.8 ± 2.8 years) were retrospectively evaluated. Complications according to Lascombes’ classification and treatment duration factors were analyzed. Mean HI was 57 ± 25 days/cm for the femur and 55 ± 24 days/cm for the tibia, with an HI > 45 days/cm in 64% of the procedures. A total of 189 procedures (79%) reported complications; 85 had an HI > 45 days/cm as the sole complication. While reducing the frame time is crucial, revising the classifications is necessary to avoid the overestimation of complications.https://www.mdpi.com/2227-9067/10/10/1586Ilizarovexternal fixatorlimb lengtheningchildleg length discrepancyhealing index |
| spellingShingle | Alessandro Depaoli Marina Magnani Agnese Casamenti Tosca Cerasoli Marco Ramella Grazia Chiara Menozzi Marina Mordenti Gino Rocca Giovanni Trisolino Is the High Healing Index a Complication of Progressive Long Bone Lengthening? Observations from a Cohort of 178 Children Treated with Circular External Fixation for Lower Limb Length Discrepancy Children Ilizarov external fixator limb lengthening child leg length discrepancy healing index |
| title | Is the High Healing Index a Complication of Progressive Long Bone Lengthening? Observations from a Cohort of 178 Children Treated with Circular External Fixation for Lower Limb Length Discrepancy |
| title_full | Is the High Healing Index a Complication of Progressive Long Bone Lengthening? Observations from a Cohort of 178 Children Treated with Circular External Fixation for Lower Limb Length Discrepancy |
| title_fullStr | Is the High Healing Index a Complication of Progressive Long Bone Lengthening? Observations from a Cohort of 178 Children Treated with Circular External Fixation for Lower Limb Length Discrepancy |
| title_full_unstemmed | Is the High Healing Index a Complication of Progressive Long Bone Lengthening? Observations from a Cohort of 178 Children Treated with Circular External Fixation for Lower Limb Length Discrepancy |
| title_short | Is the High Healing Index a Complication of Progressive Long Bone Lengthening? Observations from a Cohort of 178 Children Treated with Circular External Fixation for Lower Limb Length Discrepancy |
| title_sort | is the high healing index a complication of progressive long bone lengthening observations from a cohort of 178 children treated with circular external fixation for lower limb length discrepancy |
| topic | Ilizarov external fixator limb lengthening child leg length discrepancy healing index |
| url | https://www.mdpi.com/2227-9067/10/10/1586 |
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