CONGENITAL POSTEROMEDIAL BOWING OF TIBIA: COMPARISON OF EARLY VERSUS LATE LENGHTENINGS

I. Chaudhary; B. Sagade; N. Jagani; M. Chaudhary

doi:10.1302/1358-992X.2022.11.045

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General Orthopaedics

CONGENITAL POSTEROMEDIAL BOWING OF TIBIA: COMPARISON OF EARLY VERSUS LATE LENGHTENINGS

The British Indian Orthopaedic Society (BIOS) Annual Scientific Meeting, Mansfield, England, 7–8 July 2022.

I. Chaudhary
B. Sagade
N. Jagani
M. Chaudhary

CONGENITAL POSTEROMEDIAL BOWING OF TIBIA: COMPARISON OF EARLY VERSUS LATE LENGHTENINGS

Chaudhary I, Sagade B, Jagani N, Chaudhary M. CONGENITAL POSTEROMEDIAL BOWING OF TIBIA: COMPARISON OF EARLY VERSUS LATE LENGHTENINGS. Orthop Procs. 2022;104-B(SUPP_11):45-45. doi:10.1302/1358-992X.2022.11.045

Chaudhary, I., et al. “CONGENITAL POSTEROMEDIAL BOWING OF TIBIA: COMPARISON OF EARLY VERSUS LATE LENGHTENINGS.” Orthopaedic Proceedings, vol. 104-B, no. SUPP_11, 2022, pp. 45-45., https://doi.org/10.1302/1358-992X.2022.11.045

Chaudhary, I., Sagade, B., Jagani, N., & Chaudhary, M. (2022). CONGENITAL POSTEROMEDIAL BOWING OF TIBIA: COMPARISON OF EARLY VERSUS LATE LENGHTENINGS. Orthopaedic Proceedings, 104-B(SUPP_11), 45-45. https://doi.org/10.1302/1358-992X.2022.11.045

Chaudhary, I., Sagade, B., Jagani, N. and Chaudhary, M. (2022) “CONGENITAL POSTEROMEDIAL BOWING OF TIBIA: COMPARISON OF EARLY VERSUS LATE LENGHTENINGS.” Orthopaedic Proceedings, 104-B(SUPP_11), pp. 45-45. Available at: https://doi.org/10.1302/1358-992X.2022.11.045

Chaudhary, I., B. Sagade, N. Jagani, and M. Chaudhary. “CONGENITAL POSTEROMEDIAL BOWING OF TIBIA: COMPARISON OF EARLY VERSUS LATE LENGHTENINGS.” Orthopaedic Proceedings 104-B, no. SUPP_11 (2022): 45-45. https://doi.org/10.1302/1358-992X.2022.11.045

Chaudhary I, Sagade B, Jagani N, Chaudhary M. CONGENITAL POSTEROMEDIAL BOWING OF TIBIA: COMPARISON OF EARLY VERSUS LATE LENGHTENINGS. Orthop Procs. 2022 Nov 1;104-B(SUPP_11):45-45. https://doi.org/10.1302/1358-992X.2022.11.045

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Abstract

Congenital posteromedial bowing of tibia (CPMBT) progresses with decreasing deformity and increasing shortening. Lengthening in CPMBT has not been studied extensively. Our series compares duration and complications of lengthening in younger vs older children.

Methods

28 tibial lengthenings (23 patients) by a single surgeon, divided into two equal groups of 14 segments: group-A ≤ 5 years, Group-B > 5 years. Lengthening was done in all with external fixators. We measured preoperative (bo) and postoperative (po) deformities, initial limb length discrepancy (LLD), LLD at maturity (LLDm), % LLD, amount of lengthening (AmtL) and %L, external fixator duration (EFD) and external fixator index (EFI). We graded complications by Lascombes' criteria, results by ASAMI Bone score.

Results

Mean age was 8.8 ± 7.1 years. Follow-up was 7.9 years. Group-A had significantly greater preoperative deformities. LLD was similar in both. Expected LLD at maturity (LLDM) using the multiplier method was greater than previously reported (group-A: 4.4 – 9.5 cm; group-B: 2.5 – 9.7 cm).%L was 24% in group-A and 15.7% in group-B (p=0.002). EFD and EFI were lesser in group-A than group-B. Lascombes' triple contract was fulfilled in 11/14 lengthenings in group-A vs. 3/14 in group-B. ASAMI bone score was good and excellent in both groups.

Conclusions

In our large series of CPMBT lenghtenings, we found younger children presenting with large deformities and LLDm could be safely lengthened with lesser EFD and complications than older children