Acute correction of XXXX and simultaneous lengthening with a monolateral fixator.

@entity1 @entity2091 @entity3207 @entity6250 @entity2054 @entity85
We have reviewed, retrospectively, all @entity1 with a @entity6250 who underwent an acute correction and lengthening with a monolateral fixator between 1987 and 1996. The @entity1 were all under the age of 19 years and had a minimum follow-up of eight months after removal of the fixator. A total of 41 @entity1 had 57 corrections and lengthening. Their mean age was 11.3 years (3.2 to 18.7) and there were 23 @entity1 and 18 @entity1 . The mean maximum correction in any one plane was 23 degrees (7 to 45). In 41 bony segments (either femur or @entity2091 ) a uniplanar correction was made while various combinations were carried out in 16. The site of the osteotomy was predominantly diaphyseal, at a mean of 47% (17% to 73%) of the total bone length and the mean length gained was 6.4 cm (1.0 to 17.0). Univariate analysis identified a moderately strong relationship between the bone healing index (BHI), length gained, maximum correction and grade-II to grade-III complications. For logistic regression analysis the @entity1 were binary coded into two groups; those with a good outcome (BHI < or = 45 days/cm) and those with a poor outcome (BHI > 45 days/cm). Various factors which may influence the outcome were then analysed by calculating odds ratios with 95% confidence intervals. This analysis suggested a dose response between increasing angular correction and poor BHI which only reached statistical significance for corrections of larger magnitude. Longer lengthenings were associated with a better BHI while age and the actual bone lengthened had little effect. Those @entity1 with a maximum angulatory correction of less than 30 degrees in any one plane had an acceptable consolidation time with few major complications. The technique is suitable for @entity85 and @entity3207 , but should be used with care in the @entity2091 since the risk of a @entity2054 or neurapraxia is much greater.
