OPERATIVE TREATMENT OF POSTTRAUMATIC LIMB SHORTENING

The physiological phenomenon of changes in callus formation during dis traction was first described by Codivilla at the beginning of this cen tury. Having investigated and proved the influence of tension stress o n callus formation, Ilizarov used this as a method to treat limb short ening and deformities. Because of his remarkable results we introduced this method in our hospital in 1990, using the original Ilizarov ring fixator. From November 1990 to December 1991, we used this technique in 10 cases of combined post-traumatic bone shortening with deformity (the tibia was affected in six patients, the femur in three and the fo rearm in one). The mean shortening was 3.1 cm, the mean varus or valgu s deformity 9.5-degrees, the mean anteflexion or recurvation 8.3-degre es, and the mean rotation deformity 8.5-degrees. Distraction/correctio n lasted between 8 and 55 days (mean: 37 days). Fixation was necessary for between 60 and 339 days. If corticotomy was performed in the diap hyseal bone, fixation lasted almost twice as long (11.33 days/mm lengt hening) as in the metaphyseal area (6.55 days/mm lengthening). There w ere 14 complications, most of which were considered minor. The latter included pin infections (4), wire breaking (1) and restricted range of motion of the knee or ankle (5). Among the major complications were t wo nerve irritations, which recovered spontaneously, and two pin-induc ed local bone infections, which required surgical intervention. Achiev ement of the goals of treatment - complete correction of shortening an d deformity - was not affected by these complications.