Minimally Invasive Plate Osteosynthesis to Prevent or Treat the Deformity after Distraction Osteogenesis

Purpose: To determine the efficacy of minimally invasive plate osteosynthesis (MIPO) for distraction callus after a lengthening procedure with an external fixator. Materials and Methods: Distraction osteogenesis were performed using an external fixator for growth arrest (7 cases), congenital pseudoarthrosis of tibia (2 cases), and congenital leg length discrepancy (2 cases). MIPO was performed using a locking compression plate over the distraction callus. The mean age of the index procedure was 11 years, and mean amount of distraction was 5.4 cm. Eight were treated earlier to remove the external fixator after achieving of the target length, and 3 were treated as a salvage operation of fractures after removal. Results: In all patients, the distraction callus healed with its length or correction into the original alignment maintained. The mean external fixation index was 34.3 days/cm and the mean healing index was 52.6 days/cm. In 8 patients with the early removal of the external fixator, the mean external fixation index was 26.9 days/cm. No patient developed a deep infection or implant failure. All patients recovered their preoperative joint motion and were satisfied with their function. Conclusion: MIPO can prevent or correct a deformity after distraction osteogenesis, and allow patients to return to their daily life earlier.

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