Abstract
Purposes of the study
To assess safety, lengths gained, frame time and perform cost analysis of the technique of submuscular plating to the femur and tibia following distraction osteogenesis.
Introduction
Since 2005 we have performed submuscular plating to the femur and tibia after distraction osteogenesis in order to shorten time in external fixator.
Aim
To assess safety, lengths gained, frame time and perform cost analysis
Methods
Retrospective analysis using notes and digital radiographs, with cost codes for 2011 prices
Patients
23 patients (14 male), mean age 11 (range 4 to 17). 14 diagnosed as congenital longitudinal deficiency. Total 37 bones lengthened (14 femur and tibia, 7 tibia only, 2 femur only). Ilizarov fixator most commonly used for tibia, LRS fixator for femur.
Results
Mean length gained 68 mm per patient, 43 mm per bone. Mean frame time 121 days. Fixator index 0.59 months/cm per patient, 0.90 months/cm per bone. Mean cost £20100 per patient, £12500 per bone, £2800 per cm length. Cost attributable to plating £5100 per patient, £3300 per bone. Complications: 5/24 had pinsite infections, 2/24 required tendon releases, 1/24 had deformity, 1/24 sustained a fracture proximal to femoral plate. No deep infections.
Conclusions
Plating after lengthening is a safe procedure with no deep infections. The frame time is low (0.6 months/cm per patient) but increases overall costs by an extra £5000.
