ELECTROMYOGRAPHIC AND NERVE-CONDUCTION CHANGES AFTER TIBIAL LENGTHENING BY THE ILIZAROV METHOD

Clinical observation of several hundred Ilizarov patients has demonstr ated prolonged muscle weakness in the involved limb after treatment. T he etiology may be either neuropathic or myopathic. Direct intraoperat ive neural injury is unusual but generally is detected immediately pos toperatively. We wished to determine the etiology of this clinical pro blem. Six consecutive patients completing tibial lengthening by the Il izarov method were examined by electrodiagnostic methods. All patients were clinically normal. Electrodiagnostic testing showed abnormalitie s in six of six deep peroneal nerves. Five of six demonstrated abnorma lities in the superficial peroneal sensory responses. In addition, two of six patients demonstrated abnormalities related to the posterior t ibial nerve. Concomitantly, sequential perioperative limb compartment pressure studies were performed in nine patients undergoing 12 tibial applications of the Ilizarov technique. Increases in mean compartment pressures to between 20 and 30 mm Hg were demonstrated after tibial os teotomy and in the first 18 hours postoperatively.