Abstract
Purpose.
To investigate the risks and types of complications associated with the Ilizarov technique of lengthening and then nailing in persons of normal height.
Methods.
Records of 26 men and 6 women aged 21 to 47 (mean, 27) years with body height of 160 to 176 (mean, 170) cm who underwent tibial and fibular lengthening and then intramedullary nailing were reviewed. They were skeletally mature healthy persons, with no systemic/local bone disease, deformity or limb length discrepancy. Pain was assessed using the visual analogue scale (VAS). Patient satisfaction in terms of the treatment outcomes and expectations was also assessed. Complications encountered during or after treatment were recorded.
Results.
The mean lengthening achieved was 7.6 (range, 3.5–12) cm or 26% (range, 10–40%) of the original length. The mean duration of external fixation was 96 (range, 45–135) days. The mean follow-up duration after intramedullary nailing was 38.7 (range, 24–93) months. The mean VAS pain score was 9.3 at week 1, 6.6 at week 4, and 5.7 at week 8. After intramedullary nailing, the mean VAS pain score was 2.6 at week 4, 0.9 at month 6, and 0.3 at year 1. 91% of the patients were satisfied with the outcome at week 6; 81% after intramedullary nailing, and 94% at the one-year follow-up. Four patients had revision operations: one for pin exchange owing to pin bending after a fall, one for adjusting external rotation of the tibia after nailing, one for bone grafting for delayed union, and one for drainage of a haematoma just after nailing.
Conclusion.
Most complications related to patient discomfort and psychological stress, which were important issues in this type of patients.