Aims and objectives
Skeletal dysplasia is a common musculoskeletal disease in children,
manifested by severe function disorders,
limb shortening and deformation [1-3].
Surgical treatment is aimed at axial correction and limb lengthening [4-6].
Radiological method allows to control distraction regenerate formation and to study its features.
However,
multiple X-ray examinations during the treatment lead to high radiation exposure in pediatric patients.
Therefore,
it is worth using ultrasound imaging in early stage of reparative process.
The aim of our research was to study the dynamics of bone regenerate formation...
Methods and materials
The results of radiographic and ultrasound examination of 64 patients (average age 11.6±2.3 years) with congenital limb shortening and deformation were analyzed (fig.1).
All patients were divided into two groups: group I – patients aged 6-10 years (n=34),
group II – aged 11-15 years (n=30).
X-ray examination was performed before the surgical treatment.
Osteotomy was made to correct deformation and elongate limbs.
Compression-distraction osteosynthesis with a rod external fixator was performed.
Distraction started between 4-6 days after surgery,
and this fact conforms with the findings...
Results
Signs of the distraction regenerate formation became visible in 10 days of distraction.
We saw a few cloud-like low intensity shadows in 35 (54.7%) patients on plain radiographs (fig.
4),
while ultrasound images showed visible hyper-echogenic structures in 60 (93.8%,
p≤0.01) patients (fig.
5).
At the end of the distraction period (in 40-45 days),
high intensity linear shadows and ‘growth-zone’ in the new bone center were determined on X-ray films in all patients (fig.
6).
Ultrasound image showed 1.5 cm and 2 cm cysts within...
Conclusion
Ultrasound method is more effective in early distraction period compared with radiography,
this fact conforms with the findings of the other authors [7].
Use of ultrasound method could help diminish the number of X-ray examinations and reduce radiation exposure.
Radiography is the basic method to study shape,
size,
structure,
type of growth of the distraction bone regenerate in limbs lengthening assessment to predict the treatment duration.
References
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Krieg AH.
Current concepts of leg lengthening.
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2. Bedoya MA,Chauvin NA,Jaramillo D,et al.
Common patterns of congenital lower extremity shortening: diagnosis,
classification,
and follow-up.
Available from: https://doi.org/10.1148/rg.2015140196.
Accepted: October 10,
2014
3. Park K-W,Garcia RN,Rejuso CA,
et al.
Limb Lengthening in Patients with Achondroplasia.
Yonsei Med J 2015; 56(6): 1656–1662
4. Dabis J,
Templeton-Ward O,Lacey AE,Narayan B,et al.
The history,
evolution and basic science of osteotomy techniques. Strategies Trauma Limb Reconstr 2017: 12(3):169–180
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Seah M,
Fragomen...