Short communicationO 087 - Gait patterns of patients with leg length discrepancies who had femur lengthening surgery with external fixator or intramedullary magnetic nail
Introduction
The researches has shown that leg length discrepancies (LLD) alter the kinematics and kinetics of gait. Skeletal distraction with external fixators and intramedullary magnetic nails are common techniques in the treatment of patients with LLD. The purpose of this study was to compare the changes in kinematic and kinetic data of sagittal, coronal and transverse planes of pelvis, hip, knee and ankle in both extremities in patients who undergone femur lengthening surgery with external fixator or intramedullary magnetic nail and to evaluate the effectiveness of different surgical techniques on walking by three-dimensional gait analysis (3DGA). We hypothesized that compensatory mechanisms during gait continue even in cases where there is no difference in leg length radiologically and these mechanisms are more prominent in patients treated with the external fixator.
Section snippets
Research question
Does gait patterns of patients with LLD who had femur lengthening surgery with an external fixator or intramedullary magnetic nail return to normal?
Methods
This study consisted of eighteen patients with LLD 2 cm or greater without associated neuromuscular diseases. The patients were divided into two groups of nine according to the surgery done. The group 1 is composed of patients treated with the external fixator and group 2 the ones treated with a magnetic nail. 3DGA data were collected with VICON Bonita Motion System postoperatively.
Results
The average discrepancy was 4.6 cm in group 1 and the mean follow-up time was 41 months. In group 2, the average discrepancy was 5.7 cm and the mean follow-up time was 37 months. No significant difference was observed between the groups in terms of temporo-spatial parameters. The patients in the 2nd group had less anterior pelvic tilt (p:0.01) and more hip extension during stance phase as compared to the patients in 1st group (p:0005). All the patients had lower pelvic oblicity on the operated
Discussion
Our study demonstrated that although there is no radiographic difference in leg length after surgery, the abnormalities in kinematics and kinetics of lower limbs joints during walking still have continued and this is more prominent in patients who treated with the external fixator.