Paramètres cliniques influençant le traitement des anomalies torsionnelles du membre inférieur par la méthode d’Ilizarov - 08/07/14

Clinical factors affecting lower limb torsional deformities treatment with the Ilizarov method

Doi : 10.1016/j.rcot.2014.06.005

P. Morasiewicz ^a,^⁎ , J. Filipiak ^b, K. Krysztoforski ^b, S. Dragan ^a
^a Department and Clinic of Orthopaedic and Traumatologic Surgery, Wrocław Medical University, ul. Borowska 213, 50-556 Wrocław, Pologne
^b Division of Biomedical Engineering and Experimental Mechanics, Wrocław University of Technology, Wrocław, Pologne

^⁎Auteur correspondant.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Tuesday 08 July 2014
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Abstract

Introduction

One of the many uses of the Ilizarov fixator is for torsional deformities correction. Rotational and translational bone displacement related to torsional deformities correction includes the additional tension stresses, which affects the biology of the regenerated bone. Understanding the clinical factors will assist in designing the optimal treatment strategy, thus possibly improving the outcomes.

Materials and methods

It was a retrospective case series study. The study examined 56 patients. The mean follow-up time was 5 years and 6 months. The mean age at the start of treatment was 19 years and 10 months. Patients underwent derotational corticotomies of distal metaphysis of the femur or proximal metaphysis of the tibia using the Ilizarov method. In these patients, following derotational corticotomies with the Ilizarov method numerous variables were defined and their effect evaluated: the selected treatment strategy, the rate, size, type, and level of derotation on complications, the alignment index, the correction coefficient, the elongation index, and deformation correction factor.

Results

The differences in the values of alignment index and deformation correction factor in this study subgroups were not statistically significant. We found differences in the elongation index and correction coefficient in a number of subgroups.

Discussion

In the case of correcting torsional deformation without significant elongation, acute correction and with a value of >30° does not significantly affect the results. Treatment strategy, type and level of derotation had no major influence on torsional deformities treatment.

Level of evidence

Case-control study III.

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Keywords : Lower extremity deformities, Torsionnal deformities, Derotation osteotomy, Corticotomies, Ilizarov

☆	Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (sciencedirect.com) en utilisant le DOI ci-dessus.