DISTRACTION OSTEOGENESIS IN CONGENITAL LIMB LENGTH DISCREPANCY - A REVIEW

This paper reviews the technique of callotasis used to correct limb le ngth discrepancy due to congenital causes. Many more lower than upper limb lengthening procedures have been reported. Despite the low compli cation rate reported by the originators of the technique, patients und ergoing limb lengthening because of congenital problems are at signifi cant risk of pin tract sepsis, joint contracture, nerve palsies, angul ar deformities and fracture through the regenerate bone. A minority of studies focus specifically on limb lengthening for congenital defects . Most series simply include some congenital patients, but it is diffi cult to retrieve the data, and to generalize from them. The amount of lengthening with an acceptable complication rate should not exceed 25% ; of the initial bone length. Even using circular frames with small pi ns, practically all patients may be expected to develop at least one c omplication each, ranging from pin tract infection to the necessity of carrying out additional unplanned operative procedures either during or after the treatment period. The prevalence of major complications s eems to be correlated with the complexity and the duration of the trea tment. The functional outcome and tile psychological problems associat ed with a lengthy procedure, which map require long periods of repeate d hospitalization, have only rarefy been studied. However, it appears that prolonged strength loss is frequent, and that significant psychol ogical morbidity is experienced. Patients and their families should be counselled before and during the procedure on these lesser known aspe cts of callotasis lengthening.