Surgical lengthening of short deformed extremities has been one of the most challenging experiences of orthopedic surgery of this century. Since the first femoral lengthening was accomplished by Codivilla in 1905. Numerous authors have reported
series
with high complication rates and significant morbidity.
With the introduction of more physiologic methods of lengthening proposed by Ilizrov and based on bone regeneration under the conditions of tension stress. the bone healing problems have become far less common. But the neurologic complications
are
sometimes severe or permanent.
From October 1988 to July 1992 at the department of orthopedic surgery, Yonsei university College of Medicine, 62 patients(84 tibiae) underwent the operation of lengthening and deformity correction of the tibia by the technique of Ilizarov.
We experienced 13 cases (15.5%) of neurologic complications during or after the operative procedures and analyzed them for the causative factors. Among 13 cases, there were 1 transient tibial nerve palsy, 3 transient superficial peroneal nerve
palsy, 3
transient deep erpoeal nerve palsy, and 1 incomplete common peroneal nerve palsy. One case of common peroneal nerve injury was caused by pin penetration.
We assumed that the factors related to neurologic complications are large amount of lengthening, simultaneous correction of multiplane deformities, post-traumatic alteration of normal anatomy, wrong surgical technique especially in obese patient,
and
simultaneous lengthening of both femur and tibia.
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