Treatment of Posttraumatic Lower Limbs Length Discrepancy without Breach of Bone Integrity in combination with Deformity in Children and Adolescents

During the period from 1994 to 2009 two hundred nine children (aged 2 - 18 years) with posttraumatic lower limbs length discrepancy without breach of bone integrity in combination with deformity were treated on. Corrective osteotomy or the combination with elongating osteotomy by monolocal methods were the main treatment techniques. Bi- and polylocal techniques were mainly applied when deformity was localized in an unfavorable for elongation zone and in significant shortening. A risk group for delayed regenerate ossification was identified. In that group treatment was supplemented with preventive bone plasty using either auto- or allografts in the zone of osteotomy. For objective complex evaluation of distraction regenerate condition in dynamics roentgenologic examination and ultra-sound investigation as well as elaborated method for determination of relative bone regenerate mineral density were used. The latter method enabled to study the regenerate density using digital image of standard roentgenogram and graphic computer program. Differentiated approach to the treatment and monitoring of distraction regenerate condition enabled to achieve excellent and good results in 84% of cases.

lower limbs length discrepancy, distraction regenerate, relative mineral density, preventive bone plasty