What’s new in pediatric lower limb reconstruction?

Author:

Radler Christof1ORCID,Calder Peter2,Eidelman Mark3,Horn Joachim45,Kold Søren6,Langendörfer Micha7ORCID,Manner Hans Michael8,Sedki Imad2ORCID,Vogt Bjoern9

Affiliation:

1. Department of Pediatric Orthopaedics and Adult Foot and Ankle Surgery, Orthopaedic Hospital Speising, Vienna, Austria

2. Royal National Orthopaedic Hospital, London, UK

3. Ruth Children’s Hospital, Rambam Health Care Campus, Technion Faculty of Medicine, Haifa, Israel

4. Section of Children’s Orthopaedics and Reconstructive Surgery, Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway

5. Institute of Clinical Medicine, University of Oslo, Oslo, Norway

6. Department of Orthopaedics, Aalborg University Hospital, Aalborg, Denmark

7. Department of Paediatric Orthopaedics, Asklepios Klinik Sankt Augustin, Sankt Augustin, Germany

8. Department of Paediatric Orthopaedics, Schulthess Clinic, Zurich, Switzerland

9. Paediatric Orthopaedics, Deformity Reconstruction and Foot Surgery, Muenster University Hospital, Muenster, Germany

Abstract

The last years brought many advances relevant to lower limb reconstruction. It feels like guided growth has been looked at from every angle, and still there are new emerging concepts like rotational guided growth waiting to be validated. New hexapod external devices are more accurate and easier to use, and new unilateral fixators allow for more versatile and stable fixation and lengthening. Intramedullary nail lengthening has found its place as a standard procedure for various diagnoses in children and young adults. First results of new and exciting approaches like extramedullary implantable nail lengthening and lengthening plates have been reported. Pharmaceutical treatment has changed the course of certain diseases and must be integrated and considered when making a reconstructive treatment plan. As reconstructive surgery is rapidly advancing so are the technical options for prosthetic fitting, which makes it difficult for caregivers as well as for parents to make the decision between reconstruction and amputation surgery for the most severe cases of congenital deficiencies. This review is highlighting new developments of lower limb reconstruction and is reviewing the current literature.

Publisher

SAGE Publications

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