We believe that by the use of our apparatus, Kirschner wires instead of the heavier pins, the insertion of a wire into the os calcis and one into the distal fragment of the tibia, more thorough division of the fascia, division of the interosseous membrane, and complete circumferential division of the periosteum of the tibia and fibula, all at the level of the fibular osteotomy in a non-binding zone, better control and alignment, of the fragments is maintained; therefore, osteomyelitis is less apt to occur, the same relationship between the tibial and fibular fragments is assured during the lengthening process, and the foot is held in a more normal position.
The apparatus is designed to rest on any flat surface so that it is no longer necessary to suspend the limb from an overhead frame or tie the patient to a bed during the lengthening. Plaster may also be readily applied with great ease while the limb remains in the apparatus, so there is no danger of slipping of the fragments; this also permits the patient to begin walking at an earlier date.
By the various changes in the technique of the operation, not only is the resistance of the fascial structures entirely overcome, thereby diminishing the amount of pain to the patient caused by the lengthening process, but also the periosteum is preserved so that it may amply cover the gaps in the tibia resulting from the lengthening process.
The cases that have been treated by this new method form the basis of a paper that will be published at some subsequent date.
In concluding, the authors wish to reiterate the fact that credit for developing the bone lengthening procedure in this country rightfully belongs to Abbott and his coworkers, and that the intention of this contribution is not in a spirit of criticism, but rather to emphasize the importance of certain additional technical and mechanical features, which in the authors' hands have reduced the number of complications previously encountered.
(C) 1932 All Rights Reserved.The Journal of Bone and Joint Surgery, Inc.