Results of Femoral Lengthening Using the Ilizarov Technique

Abstract

Summary: We report the results of 36 femoral lengthenings in 30 consecutive patients using the Ilizarov technique. Patient age at surgery in 19 boys and 11 girls averaged 13.4 years (range, 5-18). Minimum follow-up was 2 years. The etiology of femoral shortening was congenital in 21 femora and acquired in 15. Twelve femora underwent concomitant correction of associated angular de-formities during treatment. The average lengthening was 8.3 cm (range, 3.5-12 cm) with a treatment time of 6.4 months (range, 2.5-12). The mean number of surgeries per patient was 2.3, including apparatus application and removal. Lengthening index (months of treatment/centimeter lengthening) was 0.74. Complications included premature consolidation in four patients, malunion of >10° in two patients, and residual limb length inequality (<2 cm) in two. There were two instances of knee dislocation. No osteomyelitis, ring sequestra, neurologic or vascular compromise, compartment syndrome, hypertension, or hip or knee dislocations occurred. Psychological problems necessitated cessation of lengthening in two patients. These results show a significant improvement over previous reports of earlier techniques of femoral lengthening in terms of greater lengthening, simultaneous deformity correction, and fewer major complications.