The latest research in limb lengthening and deformity correction is covered in the new JBJS Guest Editorial What’s New in Limb Lengthening and Deformity Correction. Here, we present the 5 most compelling studies, as selected by coauthor Jill C. Flanagan, MD, FAAOS.
Basic Science
The pattern of bone formation during intramedullary lengthening of goat tibiae was analyzed in a pilot study using plain radiographs, micro-computed tomography, and histology. The researchers identified a new “inner zone” observed on histological sections of regenerate bone1.
Limb Lengthening
In a single-center study that included 420 patients, researchers investigated the incidence of surgical site infection (SSI) following femoral and/or tibial lengthening with magnetic intramedullary lengthening nails. The rates of SSI and deep infection were 3.3% and 2.9%, respectively. Among patients with an infection, osteomyelitis and a history of limb lengthening via an external fixator were common2.
Trauma
Researchers assessed the mid- to long-term outcomes in 225 patients with Gustilo-Anderson type III-B open tibial fractures treated with an Ilizarov ring fixator and an orthoplastic approach. Circular frames were used for a mean of 6.4 months. The deep infection rate (the primary outcome) was 3.5%. Union was achieved in 98.2% of patients3.
Bone Defects
JBJS Case Connector published the first report of the use of automated struts for balanced cable trifocal bone transport. The patient was a 14-year-old boy with a 10.5-cm bone defect. The study authors concluded that “automated balanced cable transport is a viable option for segmental bone defects”4.
Osseointegration
Outcomes at a minimum of 2 years of follow-up were reported in a study of 21 patients undergoing transtibial osseointegration for socket prosthesis-related issues following traumatic amputation. Significant improvements in function and prosthesis use were observed. Three patients underwent a total of 4 reoperations for soft-tissue-related issues, and 1 implant was removed5.
What’s New in Limb Lengthening and Deformity Correction is freely available at JBJS.org.
What’s New by Subspecialty
Each month, JBJS publishes a review of the most pertinent studies from the orthopaedic literature in a select subspecialty. To read the reports, visit the What’s New by Subspecialty collection at JBJS.org.
Recent OrthoBuzz posts include: What’s New in Orthopaedic Trauma, What’s New in Spine Surgery, and What’s New in Foot and Ankle Surgery.
Image reproduced from: Haruno LS, Owen JK, Marecek GS. Automated balanced cable trifocal bone transport: a case report. JBJS Case Connect. 2024 Dec 12;14(4).
References
- Bafor A, Isler A, Sprangel K, McBride-Gagyi S, Iobst CA. Qualitative and quantitative assessment of the regenerate bone formed during intramedullary limb lengthening using a goat (caprine) tibia model: a pilot study. J Limb Lengthening Reconstr. 2024 Jul-Dec;10(2):78-85.
- Bains SS, Dubin JA, Green C, Herzenberg JE, McClure PK. Infection rates and risk factors with magnetic intramedullary lengthening nails. J Orthop. 2024 Apr 18;55:124-8.
- Madhvani KR, Fong A, Clark T, Eng K, Condurache C, McGregor-Riley J, Shields DW. Mid to long-term outcomes of Grade III-B open tibial fractures definitively managed with a circular frame: a 13-year prospective database study at a major trauma center. J Orthop Trauma. 2024 Aug 1;38(8):447-51.
- Haruno LS, Owen JK, Marecek GS. Automated balanced cable trifocal bone transport: a case report. JBJS Case Connect. 2024 Dec 12;14(4).
- Muderis MA, Tan YC, Lu W, Tetsworth K, Axelrod D, Haque R, Akhtar MA, Roberts C, Doshi K, Al-Jawazneh S, Hoellwarth JS. Transtibial osseointegration following unilateral traumatic amputation: an observational study of patients with at least two years follow-up. Injury. 2024 Jun;55(6):111568.
