Treatment of length discrepancy and axial deviations of lower extremities after septic osteoarthritis – obstacles, complications, analysis of results
Journal Title: Postępy Nauk Medycznych - Year 2012, Vol 25, Issue 6
Abstract
Septic hematogenous osteomyelitis and arthritis in neonates and newborns may be the source of many late complications leading to leg length discrepancies and axial deviations. The destruction of joint structures and especially of the growth plate leads to serious deformities of the skeleton requiring complicated surgical treatment.<br><b>Aim. </b>The aim of the study is to present the course and results of lengthening and correction of axial deformities of lower extremities, as well as the complications appearing during the treatment. The material consists of 27 patients, aged between 7 and 22 years with leg length inequality ranging from 1.5 to 15 cm and axial deviations in the horizontal and/or sagittal plane.<br><b>Material and methods.</b> Medical records with clinical data about leg length inequality, axial deviations, limited range of motion, joint instability were reviewed. Complication appearing during the treatment, divided into problems, obstacles and real complications, were also analyzed. Final clinical and radiographic results were presented as well.<br><b>Results.</b> Three of 27 patients were operated twice, because of the recurrence of the axial deviation or the fact that the huge leg length discrepancy could not be managed in a single procedure. The most frequent problems during the elongation were superficial infections and transient limitation of the range of motion in the knee; the most frequent obstacles were premature consolidation of the elongated bone and fractures of the callus during lengthening. The complications included subluxation of knee and hip and too early ending of the treatment due to a total non-compliance with the patient.<br><b>Conclusions. </b>During the management using the Ilizarov device many complications may appear. A good cooperation with the patient and his patients is necessary, as well as a proper physiotherapeutic support to avoid limitations of the range of movements in the joints.
Authors and Affiliations
Szymon Pietrzak, Adam Czwojdziński, Paweł Polaczek, Marcin Tyrakowski, Jarosław Czubak
Keywords
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