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What’s New in Limb Lengthening and Deformity Correction 2022

OrthoBuzz for Surgeons
Sagittal radiograph of a distal femur and photograph of intra-articular lesion.

Each month, JBJS publishes a review of the most pertinent studies from the orthopaedic literature in a select subspecialty. Here, we spotlight 5 of the 75 papers featured in the new “What’s New in Limb Lengthening and Deformity Correction” article, as selected by co-author Christopher A. Iobst, MD, FAOA. 

Remembering G.A. Ilizarov 

– 2021 marked what would have been the 100th birthday of Professor G.A. Ilizarov. Several publications discuss his contributions to orthopaedics. One article shares personal memories of learning from Ilizarov and how he influenced the author’s life1.    

Pediatric Limb Reconstruction 

– A recent study examined patient-reported outcome measures (PROMs) used in pediatric limb deformity surgery2. The authors found the measures “highly heterogeneous” and underutilized. They advocate for additional research to validate a current PROM in pediatric limb deformity or to develop a new instrument. They note that the pediatric PROMIS (Patient-Reported Outcomes Measurement Information System) or the PODCI (Pediatric Outcomes Data Collection Instrument) could be used as a benchmark. 

Limb Lengthening 

– The traditional algorithm for limb-length discrepancies holds that patients with a discrepancy of <5 cm should not be offered lengthening surgery as a treatment option. However, the development of intramedullary lengthening nails and improved techniques may be challenging this. One study demonstrated that patients prefer limb lengthening over limb shortening for limb-length discrepancies of <5 cm3.  

– Another study showed a complication rate of 3% during the elective removal of 271 motorized lengthening nails4. The rate was 13% after nail removal. Complications were more common after the removal of tibial nails versus femoral nails.  

Bone Transport 

– A supplemental journal publication explores advancements in motorized intramedullary bone transport5. The history of bone transport and the progression of external fixation techniques through the use of the internal transport nail are reviewed. 

“What’s New in Limb Lengthening and Deformity Correction” is freely available at JBJS.org. 

What’s New by Subspecialty 

To access previous reports, visit the “What’s New by Subspecialty” collection at JBJS.org. 

Image from: Frost MW, Kold S, Rahbek O, Bafor A, Duncan M, Iobst CA. Complications in elective removal of 271 bone lengthening nails (FITBONE, PRECICE and STRYDE). Strategies Trauma Limb Reconstr. 2021 May-Aug;16(2):110-15.© Jaypee Brothers Medical Publishers. https://creativecommons.org/licenses/by-nc-sa/4.0/

References 

  1. Cherkashin A. Ilizarov – The teacher. J Limb Lengthening Reconstr. 2021;7(1):70-4.  
  2. Amakoutou K, Liu RW. Current use of patient-reported outcomes in pediatric limb deformity surgery. J Pediatr Orthop B. 2021 Jul 1;30(4):399-404. 
  3. Iobst C, Bafor A. Patient perspectives in the choice of management of leg length discrepancy. J Limb Lengthening Reconstr. 2021;7(1):8-12.  
  4. Frost MW, Kold S, Rahbek O, Bafor A, Duncan M, Iobst CA. Complications in elective removal of 271 bone lengthening nails (FITBONE, PRECICE and STRYDE). Strategies Trauma Limb Reconstr. 2021 May-Aug;16(2):110-15.  
  5. Watson JT. State of the art: advancements in motorized intramedullary bone transport. J Orthop Trauma. 2021 Oct 1;35(Suppl 4). 
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