TREATMENT OF DEFORMITY OF THE LOWER-LIMB IN ADULTS WHO HAVE OSTEOGENESIS IMPERFECTA

The Ilizarov method of lengthening was used to correct deformities of the lower extremity in six patients who had type-I osteogenesis imperf ecta, as categorized by Sillence et al, The average age was thirty-one years (range, fourteen to fifty-one years), The deformities included shortening of four tibiae and three femora as well as an angular malal ignment (average, 28 degrees; range, 20 to 40 degrees) of all four tib iae and one femur, One patient also had a non-union of the right femur . The average angular correction was 23 degrees (range, 20 to 30 degre es), The seven limb segments gained an average of 6.6 centimeters (ran ge, two to eleven centimeters) in length, All limb-length discrepancie s were corrected to within two centimeters of the length of the contra lateral limb, At an average of three years and four months (range, one year and seven months to six years), the roentgenographic appearance of the fully matured bone was comparable ,vith that of the original bo ne. There were no fractures or increases in the angulation of the segm ent of new bone, Two patients had pain when walking: it was related to a chronic pin-track infection in one and to osteoarthrosis of the ank le in the other, The functional status of four patients was improved a nd that of the other two patients was unchanged, All six patients were pleased with the outcome of the procedure. There were eighteen compli cations: stiffness of the knee in two patients; a peroneal nerve palsy in two; a superficial pin-track infection in three; and a deep pin-tr ack infection, greater-than-normal loss of blood intraoperatively, loo sening of two pins, worsening of the instability of the knee, and an i nfection in the knee in one patient each, In another patient, a Rush r od that had been placed before correction of the deformity migrated pr oximally and had to be removed after completion of the correction, The re were five fractures.