COMPLICATIONS OF USE OF THE ILIZAROV TECHNIQUE IN THE CORRECTION OF LIMB DEFORMITIES IN CHILDREN

We reviewed the records of the first forty patients who had been manag ed at our institution with the Ilizarov technique for the correction o f limb deformities, including limb-length inequality, to delineate the complications of this method of treatment. The duration of follow-up ranged from two and one-half to four years. A complication was defined as any untoward occurrence to a patient either during the course of t reatment or after removal of the fixator. A major complication was con sidered one that necessitated an additional operative procedure; cause d lasting sequelae, such as malunion, deformation of new bone, joint c ontracture or stiffness, or nerve palsy; or prolonged the treatment. A minor complication was regarded as one that responded to non-operativ e treatment and did not cause lasting sequelae, such as transient decr eased motion of the joint, paresthesia, or pin-track infection. There were eighty-eight complications - thirty-eight, major, and the remaini ng fifty, minor - in the sixty-one segments of the limb that were trea ted; this represented an average of almost one and one-half complicati ons for each segment. Twenty-nine unplanned operative procedures were performed either during treatment with the Ilizarov technique or after removal of the fixator. As anticipated, the prevalence of major compl ications was highest in the patients who had had more complex and prol onged treatment. Such complications were encountered less often as the surgeons gained experience with the procedure, but the rate of minor complications remained relatively constant, despite the increased expe rience. No correlation was found between the development of complicati ons and the etiology of the deformity, a history of previous operation s, or the limb segment that had been treated.