Results of Ilizarov external fixator lengthening compared to lengthening and then plating in management of femoral shortening in children

Abstract

Femoral shortening in children is a challenging condition with complex functional and psychological implications. We study the results of Ilizarov external fixator (IEF) lengthening compared to lengthening and then plating (LAP) in the management of femoral shortening in children. Forty patients were included in the study and equally divided randomly into 2 groups, in group I LAP was used and in group II lengthening by IEF only was done. The two groups were analyzed for postoperative variables to adjudge the surgical outcomes. The mean follow up time was 24.05 ± 2.99 months, The gained length was 5.60 ± 0.60 cm in group 1 and 5.48 ± 0.64 cm in group II, group I had a shorter external fixator period (3.96 ± 0.22) months, better healing index (24.6 ±2.76) days/cm, earlier complete weight-bearing (5.55 ± 0.78) months than group II. The period of hospitalization for group I was longer more than group II. The complications were less in group I (n=7, 35%) than in group II (n=11, 55%). There was no significant correlation between the healing index with age, also no significant difference was detected between the healing index and gender. There was a significant correlation between the gained length and complete weight-bearing. This study efficiently demonstrates that LAP may be better than lengthening with IEF alone in the management of femoral shortening in children.