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. 2016 Mar 30;21(5):e25340.
doi: 10.5812/traumamon.25340. eCollection 2016 Nov.

Tibial Lengthening Using a Fixator-Assisted Lengthening Plate: A New Technique

Haci Bayram Tosun  1 , Ismail Agir  1 , Seyitali Gumustas  1 , Sancar Serbest  2 , Abuzer Uludag  1 , Suat Celik  1
Affiliations

Tibial Lengthening Using a Fixator-Assisted Lengthening Plate: A New Technique

Haci Bayram Tosun et al. Trauma Mon. .

Abstract

Background: There are many techniques that are used for limb lengthening. Lengthening a limb over a plate is an alternative choice used in children or when using an intramedullary nail is difficult.

Objectives: In this study, we presented a new technique for tibial lengthening using a monolateral external fixator over a lengthening plate.

Materials and methods: For tibial lengthening, a monolateral external fixator was attached to the composite bone model medially. After a corticotomy was performed, the lengthening plate was placed laterally. Three locking screws were inserted proximally, and two cortical screws were inserted into a lengthening hole that was 1 cm below the osteotomy site. We avoided contact between the screws of the lengthening plate and the pins of the external fixator. During bone lengthening with the monolateral external fixator, the screws at the lengthening hole were able to slide distally with the distal segment of the tibia to allow for tibial elongation. Two locking screws were fixed at the distal locking holes of the plate when the bone elongation was complete. The external fixator was then removed.

Results: The fixator-assisted lengthening plate allowed bone lengthening without malalignment. There were no mechanical problems associated with the external fixator during the lengthening process. Plate osteosynthesis was stable after the fixator was removed. There was no contact between the screws of plate and the Schanz pins of the external fixator under C-arm fluoroscopy.

Conclusions: The fixator-assisted lengthening plate technique helps to maintain the stability and alignment at both sides of an osteotomy during tibial elongation. It allows the early removal of the external fixator immediately after lengthening is completed. This technique can be applied in children with open physes and in patients with a narrow medullary canal who are unsuitable for limb lengthening over an intramedullary nail.

Keywords: External Fixator; Lengthening Plate; Malalignment; Tibial Lengthening.

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Figures

Figure 1.
Figure 1.. The External Fixator, Lengthening Plate, and Osteotomy Site are Shown Before Being Attached to a Tibial Composite Bone Model for Bone Lengthening
Figure 2.
Figure 2.. The External Fixator, Lengthening Plate, and Osteotomy Site are Shown After Lengthening of the Tibial Composite Bone Model
Figure 3.
Figure 3.. The External Fixator was Removed and the Lengthening Plate was Secured Using Two Extra Locking Screws Distal to Lengthening Hole
Figure 4.
Figure 4.. The Fixator-Assisted Lengthening Plate
Figure 5.
Figure 5.. Fluoroscopic Views A, Before and B, After Lengthening
Figure 6.
Figure 6.. Axial Compression Stress Testing
See this image and copyright information in PMC

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