Lengthening Osteotomy with or Without Elevation of the Lateral Trochlear Facet

Purpose Double and triple femoral neck lengthening osteotomies have been described to correct coxa brevis deformity. Only small studies reported the results. Our aim was to provide an overview of the outcomes of double and triple femoral neck lengthening. Methods After an extensive search of different online databases, we included studies reporting the results of double and triple femoral neck osteotomies. Clinical and radiological outcomes, and reported complications were extracted. The review process was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results After evaluating 456 articles, we included 11 articles reporting 149 osteotomies in 143 patients (31% male, 64% female, 5% unspecified). Mean age of the patients was 20 years (range 7 years to 52 years). Indications were developmental hip dysplasia (51%), Perthes disease (27%), infection (6%), post-trauma (4%), congenital disorders (2%), slipped capital femoral epiphysis (1%), idiopathic (3%) and unknown (6%). The mean limb length discrepancy reduced by 12 mm (0 mm to 40 mm). In total, 65% of 101 positive Trendelenburg sign hips experienced improvement of abductor muscle strength. An 18% (9% to 36%) increase could be found in functional hip scores. Mean increase in articulo-trochanteric distance was 24 mm (10 mm to 34 mm). Five patients older than 30 years at the time of osteotomy and two younger patients with prior hip incongruency had disappointing results and required arthroplasty. In all, 12 complications occurred in 128 osteotomies, in which complications were reported. Conclusions Double and triple femoral neck lengthening osteotomies in coxa brevis show good results with few complications in the literature, especially in young patients with non-arthritic hips. Level of evidence III

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Results of Capito-hamate Lengthening Osteotomy Fixed with Herbert Screw to Compensate for Decreased Carpal Height in Advanced Kienböck's Disease

The Journal Of Hand Surgery ◽

10.1016/s0363-5023(10)60092-5 ◽

2010 ◽

Vol 35 (10) ◽

pp. 17

Author(s):

Muhammad A. Quolquela

Keyword(s):

Kienböck’S Disease ◽

Kienböck's Disease ◽

Herbert Screw ◽

Lengthening Osteotomy ◽

Carpal Height ◽

Kienbock’S Disease

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Comparison of Allograft and Bovine Xenograft in Calcaneal Lengthening Osteotomy for Flatfoot Deformity in Cerebral Palsy

Journal of Pediatric Orthopaedics ◽

10.1097/bpo.0000000000000822 ◽

2017 ◽

Vol 37 (3) ◽

pp. e202-e208 ◽

Cited By ~ 5

Author(s):

Jason Rhodes ◽

Alfred Mansour ◽

Allison Frickman ◽

Breanna Pritchard ◽

Katherine Flynn ◽

...

Keyword(s):

Cerebral Palsy ◽

Lengthening Osteotomy ◽

Calcaneal Lengthening ◽

Bovine Xenograft

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Fibula lengthening osteotomy to correct valgus mal-alignment following total ankle arthroplasty

Foot and Ankle Surgery ◽

10.1016/j.fas.2009.11.002 ◽

2012 ◽

Vol 18 (2) ◽

pp. 144-147 ◽

Cited By ~ 10

Author(s):

Benjamin Thomas Brooke ◽

Nick John Harris ◽

Samer Morgan

Keyword(s):

Total Ankle Arthroplasty ◽

Ankle Arthroplasty ◽

Lengthening Osteotomy

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Five-year results of a clinical pilot study utilizing a pedicle-lengthening osteotomy for the treatment of lumbar spinal stenosis

Journal of Neurosurgery Spine ◽

10.3171/2017.11.spine16664 ◽

2018 ◽

Vol 29 (3) ◽

pp. 241-249 ◽

Cited By ~ 1

Author(s):

Sergey Mlyavykh ◽

Steven C. Ludwig ◽

Christopher K. Kepler ◽

D. Greg Anderson

Keyword(s):

Pilot Study ◽

Adverse Events ◽

Spinal Stenosis ◽

Spinal Canal ◽

Ct Scans ◽

Time Points ◽

Lengthening Osteotomy ◽

Lumbar Spinal ◽

Disease Specific

OBJECTIVELumbar spinal stenosis (LSS) is a common condition that leads to significant disability, particularly in the elderly. Current therapeutic options have certain drawbacks. This study evaluates the 5-year clinical and radiographic results of a minimally invasive pedicle-lengthening osteotomy (PLO) for symptomatic LSS.METHODSA prospective, single-arm, clinical pilot study was conducted involving 20 patients (mean age 61.7 years) with symptomatic LSS treated by a PLO procedure at 1 or 2 lumbar levels. All patients had symptoms of neurogenic claudication or radiculopathy secondary to LSS, and had not improved after a minimum 6-month course of nonoperative treatment. Eleven patients had a Meyerding grade I degenerative spondylolisthesis in addition to LSS. Clinical outcomes were measured using the Oswestry Disability Index, Zürich Claudication Questionnaire, 12-Item Short Form Health Survey, and a visual analog scale for back and leg pain. Procedural variables, neurological outcomes, adverse events, and radiological imaging (plain radiographs and CT scans) were collected at the 1.5-, 3-, 6-, 9-, 12-, 24-, and 60-month time points.RESULTSThe PLOs were performed through percutaneous incisions, with minimal blood loss in all cases. There were no operative complications. Four adverse events occurred during the follow-up period. Statistically significant improvement was observed in each of the outcome instruments and maintained over the 5-year follow-up period. Imaging studies, reviewed by an independent radiologist, showed no evidence of device subsidence, migration, breakage, or heterotopic ossification. Thin-slice CT scans documented healing of the osteotomy site in all patients at the 6-month time point and an increase of 115% in the mean cross-sectional area of the spinal canal.CONCLUSIONSTreatment of patients with symptomatic LSS with a PLO procedure provided substantial enlargement of the area of the spinal canal and favorable clinical results for both disease-specific and non–disease-specific outcome measures at all follow-up time points out to 5 years. Future research is needed to compare this technique to alternative therapies for LSS.

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