ArticleChildren (Basel, Switzerland)2023
Is the High Healing Index a Complication of Progressive Long Bone Lengthening? Observations from a Cohort of 178 Children Treated with Circular External Fixation for Lower Limb Length Discrepancy.
Article in Children (Basel, Switzerland), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 7 citations in OpenAlex.
- Challenges in Reconstruction and Limb Lengthening Surgery for Congenital Lower Limb Deficiencies.Journal of clinical medicine · 2026Review
- Treatment Efficiency Following Pediatric Tibial Lengthening Using Monolateral External Fixation: The Role of Surgical Planning and Postoperative Complications.Journal of clinical medicine · 2026Article
- Does Ossein-Hydroxyapatite Complex Improve the Results of Lower-Leg Lengthening Osteotomies with the Ilizarov Method?Life (Basel, Switzerland) · 2026Article
- Adjunctive Therapies in Long-Bone Distraction Osteogenesis: Clinical Evidence for Biophysical and Biologic Treatment Strategies.Journal of clinical medicine · 2026Review
- Sequential Limb Lengthening: A Novel Staged Approach Combining External Fixation and a Motorized Intramedullary Lengthening Nail for a Large Posttraumatic Tibial Defect.Case reports in orthopedics · 2026Article
- Evaluation of Physical and Mental Health in Adults Who Underwent Limb-Lengthening Procedures with Circular External Fixators During Childhood or Adolescence.Children (Basel, Switzerland) · 2024Article
- Medial Gradual Opening Osteotomy of the Tibia With Monolateral External Fixator for Correcting the Varus Deformity of the Tibia.Arthroscopy techniques · 2024Article
- Opening-Wedge High Tibial Osteotomy with a Cancellous Strut Bone Allograft Is Inadequate for Achieving Satisfactory and Lasting Correction in Neglected Infantile Tibia Vara: Results from a Cohort of 29 Patients.Journal of clinical medicine · 2024Article
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Authors and funding
9 authors at 1 institution in 1 country.
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Abstract
The use of external fixators (EFs) for lower limb lengthening is common for treating lower limb length discrepancy (LLD) in children. The concern at present revolves around extended treatment times, with some suggesting a healing index (HI) > 45 days/cm as a major complication. The aim of this study is to assess the factors affecting bone healing and treatment duration in children who undergo limb lengthening for LLD using circular EFs. A total of 240 lengthening procedures on 178 children affected by congenital or acquired LLDs (mean age at surgery 13.8 ± 2.8 years) were retrospectively evaluated. Complications according to Lascombes' classification and treatment duration factors were analyzed. Mean HI was 57 ± 25 days/cm for the femur and 55 ± 24 days/cm for the tibia, with an HI > 45 days/cm in 64% of the procedures. A total of 189 procedures (79%) reported complications; 85 had an HI > 45 days/cm as the sole complication. While reducing the frame time is crucial, revising the classifications is necessary to avoid the overestimation of complications.
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