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Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 10,
1394-1399.
doi: 10.1302/0301-620X.91B10.22325 Copyright © 2009 by British Editorial Society of Bone and Joint Surgery Limb lengthening with a submuscular locking plateC.-W. Oh, MD, PhD, Associate Professor1; H.-R. Song, MD, PhD, Professor2; J.-W. Kim, MD, Clinical Fellow1; J.-W. Choi, MD, Resident1; W.-K. Min, MD, Assistant Professor1; and B.-C. Park, MD, PhD, Professor1
1 Department of Orthopedic Surgery Kyungpook National University Hospital, 50, 2-Ga Sandok, Chung-gu, Daegu 700-721, Korea. Correspondence should be sent to Dr C.-W. Oh; e-mail: cwoh{at}knu.ac.kr
Ten patients, who were unsuitable for limb lengthening over an intramedullary nail, underwent lengthening with a submuscular locking plate. Their mean age at operation was 18.5 years (11 to 40). After fixing a locking plate submuscularly on the proximal segment, an external fixator was applied to lengthen the bone after corticotomy. Lengthening was at 1 mm/day and on reaching the target length, three or four screws were placed in the plate in the distal segment and the external fixator was removed. All patients achieved the pre-operative target length at a mean of 4.0 cm (3.2 to 5.5). The mean duration of external fixation was 61.6 days (45 to 113) and the mean external fixation index was 15.1 days/cm (13.2 to 20.5), which was less than one-third of the mean healing index (48 days/cm (41.3 to 55). There were only minor complications. Lengthening with a submuscular locking plate can successfully permit early removal of the fixator with fewer complications and is a useful alternative in children or when nailing is difficult.
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