Complications of lower limb lengthening: classification and management / 中华骨科杂志

ABSTRACT

Lower limb lengthening, especially femur lengthening and tibia lengthening, is the most commonly used and effective technique in management of limb length discrepancy and dwarfism. However, there are many complications and sequelae in clinic practice, which limits the application and development of this technique to some extent. The reasons may be related to the following two points one is the lack of sub discipline of limb lengthening in the domestic system of health and medical education, in other word, it is difficult acquired academic and clinical guidance from specialty of "Limb Lengthening and Reconstruction" in orthopedics departments and hospitals. Secondly, limb lengthening and reconstruction with its own theoretical principles and medical model is a systematic engineering and integration discipline, which cannot be completely guided by the classical orthopedic medical paradigm. The complications of lower limb lengthening have been classified according to local and general, immediate, early and late stage, or by infection and non-infection, or by problems, obstacles, complications, etc. Regarding the nature, Qin proposed a new classification for complications, which is divided into five categories from soft tissue, from joint, from bone, infective and complex. This classification method can reflect the characteristics of different types, reflect the progressive relationship, and is easy to record, distinguish, emphasize and avoid. Different types of complications can occur in different stages of lower limb lengthening, different kinds of complications can occur alone or simultaneous, and different degrees of complications can transform into each other. It requires that surgeon engaged in limb lengthening must have solid knowledge of orthopedics, and be able to quickly identify and effectively deal with various complications; the patients should fully understand and implement the key points of each step during the whole process of limb lengthening, doctors and patients should be friends to avoid and reduce the occurrence of complications.