CONGENITAL POSTEROMEDIAL BOWING OF TIBIA: EARLY VERSUS LATE LENGTHENING

Bhushan Sagade; Milind Chaudhary; Naeem Jagani; Ishani Chaudhary

doi:10.1302/1358-992X.2022.5.046

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General Orthopaedics

CONGENITAL POSTEROMEDIAL BOWING OF TIBIA: EARLY VERSUS LATE LENGTHENING

The British Limb Reconstruction Society (BLRS) Annual Meeting 2022, Brighton, England, 24–25 March 2022.

Bhushan Sagade
Milind Chaudhary
Naeem Jagani
Ishani Chaudhary

CONGENITAL POSTEROMEDIAL BOWING OF TIBIA: EARLY VERSUS LATE LENGTHENING

Sagade B, Chaudhary M, Jagani N, Chaudhary I. CONGENITAL POSTEROMEDIAL BOWING OF TIBIA: EARLY VERSUS LATE LENGTHENING. Orthop Procs. 2022;104-B(SUPP_5):46-46. doi:10.1302/1358-992X.2022.5.046

Sagade, Bhushan, et al. “CONGENITAL POSTEROMEDIAL BOWING OF TIBIA: EARLY VERSUS LATE LENGTHENING.” Orthopaedic Proceedings, vol. 104-B, no. SUPP_5, 2022, pp. 46-46., https://doi.org/10.1302/1358-992X.2022.5.046

Sagade, B., Chaudhary, M., Jagani, N., & Chaudhary, I. (2022). CONGENITAL POSTEROMEDIAL BOWING OF TIBIA: EARLY VERSUS LATE LENGTHENING. Orthopaedic Proceedings, 104-B(SUPP_5), 46-46. https://doi.org/10.1302/1358-992X.2022.5.046

Sagade, B., Chaudhary, M., Jagani, N. and Chaudhary, I. (2022) “CONGENITAL POSTEROMEDIAL BOWING OF TIBIA: EARLY VERSUS LATE LENGTHENING.” Orthopaedic Proceedings, 104-B(SUPP_5), pp. 46-46. Available at: https://doi.org/10.1302/1358-992X.2022.5.046

Sagade, Bhushan, Milind Chaudhary, Naeem Jagani, and Ishani Chaudhary. “CONGENITAL POSTEROMEDIAL BOWING OF TIBIA: EARLY VERSUS LATE LENGTHENING.” Orthopaedic Proceedings 104-B, no. SUPP_5 (2022): 46-46. https://doi.org/10.1302/1358-992X.2022.5.046

Sagade B, Chaudhary M, Jagani N, Chaudhary I. CONGENITAL POSTEROMEDIAL BOWING OF TIBIA: EARLY VERSUS LATE LENGTHENING. Orthop Procs. 2022 Apr 1;104-B(SUPP_5):46-46. https://doi.org/10.1302/1358-992X.2022.5.046

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Abstract

Introduction

Congenital posteromedial bowing of tibia (CPMBT) is characterized by a decreasing deformity and an increasing limb shortening. Our series compares the duration and complications of lengthening in younger vs older children.

Materials and Methods

We studied 28 tibial lengthenings in 23 patients, divided into two equal groups of 14 segments: group-A ≤5 years (preschool) and Group-B >5 years. We measured preoperative (bo) and postoperative (po) sagittal, coronal, and oblique plane deformities, limb length discrepancy (LLD), amount of lengthening (AmtL), percentage lengthening (%L), external fixator duration (EFD) and external fixator index (EFI). Complications were graded by Lascombes’ criteria, results by ASAMI Bone score.

Results

Mean age= 8.8 ± 7.1 years; mean follow-up= 7.9 years. Group-A had significantly greater bo-sagittal, coronal, and oblique plane deformities. LLD (3.4 cm in group-A vs. 4.1 cm in group-B) was similar in both. LLD at maturity (LLD_M) by multiplier method ranged 4.4–9.5 cm in group-A and 2.5–9.7 cm in group-B. Though AmtL (3.5 cm and 4.1 cm) was similar in both, %L was 24% in group-A and 15.7% in group-B (p=0.002). EFD (116.6 days) and EFI (33.7 days/cm) were lesser in group-A vs group-B (200.3 days, p=0.001; 50.2 days/cm, p=0.01). Lascombes’ criteria were fulfilled in 11/14 lengthenings in group-A vs. 3/14 in group-B. ASAMI bone score was good and excellent in both groups (p=0.44).

Conclusions

Younger children with large deformities and LLD_M could be safely lengthened with lesser external fixator duration and complications than in older children.