Limb lengthening is widely practised for short
stature and limb length discrepancy. Gradual callus
distraction following corticotomy, while breaching the
cortex, leaves intact the medullary canal, and
produces elongation of bone and soft tissues.
Published work has generally reported the results
of dwarfism and post-traumatic conditions. Data
regarding the correction of congenital limb length
discrepancy are not at present available.
This thesis reports the work, carried out in a
longitudinal fashion, performed on a selected group of
24 children undergoing lengthening to correct lower
and upper limb congenital length discrepancy.
The procedure, while being described by other
authors as practically risk free, proved to have a
significant number of problems, with all children
suffering from pin site infection. The children had to
be protected in a cast when the external fixation
apparatus was removed to prevent fracture of the
regenerate bone, which occurred in some of the early
patients. Also, joint contractures had to be prevented
and treated by intense physiotherapy. One child
suffered from toxic shock following septicaemia
stemming from pin site infection.
Ultrasound scanning gives valuable information on
the morphology of the regenerate bone. However, it is
probably not sensitive enough to replace serial
conventional radiographs in assessing the maturity of
the newly formed bone.
Children with a congenital short femur take two
years to return to the pre-lengthening isometric
strength of their knee extensor muscles
