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Lower Limb Lengthening in Turner Dwarfism

Authors
 Soo Bong Hahn  ;  Hui Wan Park  ;  Hyun Woo Kim  ;  Young Jin Seo  ;  Hong Jun Park 
Citation
 YONSEI MEDICAL JOURNAL, Vol.44(3) : 502-507, 2003 
Journal Title
 YONSEI MEDICAL JOURNAL 
ISSN
 0513-5796 
Issue Date
2003
MeSH
Adolescent ; Adult ; Child ; Dwarfism/diagnostic imaging ; Dwarfism/etiology* ; Dwarfism/surgery* ; Humans ; Ilizarov Technique*/adverse effects ; Leg* ; Radiography ; Retrospective Studies ; Treatment Outcome ; Turner Syndrome/complications*
Keywords
Turner dwarfism ; lower limb lengthening
Abstract
The aim of this study was to review our cases of lower limb lengthening to treat Turner dwarfism, and to speculate whether or not effective limb lengthening can be achieved in this rare condition. Twelve tibiae and 2 femora were lengthened in 6 patients using the Ilizarov method for the tibia and a gradual elongation nail for the femur. The mean age at the time of surgery was 19 years, and the patients were followed up for a minimum of 2 years. The average gain in the tibial and femoral length was 6.2 cm and 6.0 cm, respectively. The average healing index of tibia and femur was 1.9 and 1.7 months. The average tibia-to-femur ratio improved from 0.68 preoperatively to 0.81 postoperatively, and leg-trunk ratios improved from 0.88 to 0.99. Seven segments (50.0 percent) had completed the lengthening protocol without complications. Two segments (14.3 percent) had an intractable pin site infection requiring a pin exchange, and four segments (35.7 percent) had twelve complications (a nonunion at the distraction site, premature consolidation, Achilles tendon contractures and planovalgus). The overall rate of complications was 100 percent for each bone lengthened. All the patients showing a nonunion at the distraction site had a reduced bone mass, which was less than 65 percent of those of the age-matched normal population. Despite the complications, all patients were satisfied with the results, and lower limb lengthening in Turner Dwarfism believed to be a valid option. However, it may require careful management in a specialist unit in order to prevent complications during the lengthening procedure. In addition, the osteopenia associated with an estrogen deficiency leading to problems in consolidation is a difficult issue to address.
Files in This Item:
T200305933.pdf Download
DOI
10.3349/ymj.2003.44.3.502
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hyun Woo(김현우) ORCID logo https://orcid.org/0000-0001-8576-1877
Park, Hui Wan(박희완)
Hahn, Soo Bong(한수봉)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/114245
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