Lower leg lengthening based on Ilizarov technique / 中华骨科杂志

ABSTRACT

Lower leg lengthening has a history of more than 100 years. However, serious complications occurred in the early stage due to the immature device and technical conditions. The emergence of Ilizarov technology making limb lengthening is a kind of controlled operation. Based on the "Ilizarov effect", the results of limb regeneration and lengthening were obtained by slow, stable and continuous distraction of living tissues. The regeneration of bone and soft tissue is like limb development in children. Currently, the traditional Ilizarov external fixation is still the dominated method for leg lengthening. The Chinese Ilizarov external fixator and the lower leg Achilles tendon elastic lengthening external fixator are the representatives of domestic application. Other limb lengthening methods, including computer hexapod assisted orthopedic surgery (CHAOS), lengthening over nail (LON), lengthening and then nailing (LATN) and intramedullary nail lengthening system, have not been developed in China. Percutaneous transverse osteotomy at 5-6 cm below the tibial plateau is a common osteotomy method in China. This method can maximize the retention of periosteum and intramedullary blood circulation. Limb lengthening more than 4 cm is recommended by leg Achilles tendon elastic synchronous lengthening fixator with calcaneal wire fixation. Following the principle of tension-stress, the lengthening is carried out slowly. Further, the lengthening device is removed step by step according to the principle of dynamic adjustment of fixed stiffness.