Article

Growth inhibition and stimulation have both been reported
after juvenile limb lengthening. Distraction of a joint usually suspends and
unloads the growth plate and may stimulate growth. We investigated the influence
of knee joint distraction on the speed of growth after limb lengthening. METHODS
In a retrospective study, growth patterns were analyzed in 30 children mean 61
(24-109) months after limb lengthening with the Ilizarov method, each child
having more than 2 years of remaining growth. In 14 patients with knee joint
instability, the knee was bridged over during lengthening for joint
stabilization. Whether or not joint bridging and distraction would affect
patterns of growth of the lengthened limb by unloading the growth plate was
evaluated with a repeated measurements analysis of variance. RESULTS: After
lengthening procedures, the proportionate leg-length discrepancy was found to
decrease in 16 children, suggesting increased growth rate in the lengthened
limbs. A statistically significantly faster growth rate was seen in 8 of 14
patients with knee distraction as compared to patients with single bone frame
configurations. INTERPRETATION: Further research is required to investigate
whether growth stimulation is due to the surgical technique and whether joint
distraction should be recommended during limb lengthening in growing children.

Langue : ANGLAIS