Comparative Study of Ilizarov, Wagner, and Anderson Methods for Limb Lengthening (100 Lengthenings in 98 Patients)
1993
Summary One hundred lower limb lengthenings were performed in 98 patients by the Anderson (25 tibias, group A), Wagner (45 femurs, group B), and Ilizarov (16 femurs and 14 tibias, group C) methods in the Department of Orthopaedic and Traumatologic Surgery of the University of Sao Paulo School of Medicine from 1971 to 1991. Results obtained with the three methods, problems and complications observed, and comparison of healing time between the methods of lengthening used are reported. In group A, lengthening ranged from 3 to 6 cm (average 4.2 cm); healing time ranged from 121 to 331 days (average 196.88 days), with an average lengthening index of 1.72 months/cm. In group B, femoral lengthening ranged from 1 to 12.5 cm (average 4.6 cm); average healing time for group Bl (percutaneous osteotomy) was 185.4 days, and lengthening index was 1.32 months/cm; healing time for group B2 (corticotomy) was 156.3 days, with lengthening index of 1.23 months/cm. In group C, femoral lengthening ranged from 1.0 to 7.5 cm (average 4.7 cm), and healing time ranged from 58 to 441 days (mean of 185.6 days); the lengthening index was 1.31 months/cm. For Ilizarov tibial lengthening, lengthening ranged from 1.0 to 7.5 cm (average 4.5 cm), healing time ranged from 94 to 386 days (mean of 184 days), lengthening index was 1.35 months/cm. With the Anderson method, the most common complication was delayed union; with the Wagner technique, the most common complications were related to bone healing (fracture, implant failure after the second stage, nonunion); and with the Ilizarov method, the most common complication was incomplete corticotomy. Overall results were good despite the complications, and we emphasize the necessity for the surgeon to understand the principles of leg lengthening to achieve good results.
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