To examine the efficacy, safety, and clinical outcomes of distraction osteogenesis through the physis (PDO) or through subphyseal osteotomy (SPDO) in patients with atrophic-type congenital pseudarthrosis of tibia with proximal tibial dysplasia.
To validate the efficacy and safety of PDO and SPDO, radiographic and clinical parameters were compared between 5 patients who underwent proximal tibial metaphyseal or metadiaphyseal lengthening as a control (group 1) and 7 patients who underwent PDO or SPDO (group 2). Postoperative complication was also compared between the groups.
A significant difference in terms of healing index (group 1, 83.3±24.7 d/cm; group 2, 35.0±11.1 d/cm; P=0.001) and percentage increase (11.0%±3.7% vs. 23.1%±10.5%, P=0.034) was observed between the 2 groups. According to the Paley classification, group 1 included 1 “problems” case and 3 “obstacles” cases, whereas group 2 included 2 “problems” cases and 1 “obstacles” case. According to the Lascombes classification, group 1 included 2 grade IIIb cases and 3 grade IV cases, whereas group 2 included 6 grade I cases and 1 grade IIa case. Severe complications were significantly higher in group 1 compared with the group 2 (P=0.007).
This study demonstrated that PDO or SPDO can be effectively and safely performed for tibial lengthening in atrophic-type congenital pseudarthrosis of tibia patients with proximal tibial dysplasia.
*Department of Orthopaedic Surgery, Korea University Anam Hospital
†Department of Orthopaedic Surgery, Seoul National University Hospital
§Division of Pediatric Orthopaedics, Seoul National University Children’s Hospital, Seoul
‡Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
This study was conducted at Division of Pediatric Orthopaedics, Seoul National University Children’s Hospital, Seoul, Republic of Korea.
The authors have no funding source to disclose.
The authors declare no conflicts of interest.
Reprints: In Ho Choi, MD, Division of Pediatric Orthopaedics, Seoul National University Children’s Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Republic of Korea. E-mail: email@example.com.