Delayed consolidation of regenerate requiring bone grafting in children with lower limb deformity being treated with an external fixator

Purposes of the Study To study the incidence of delayed consolidation of regenerate in children undergoing correction or lengthening of lower limb deformities using an external fixator. Methods and Results Between 2006 and 2011, 150 patients with lower limb deformities (excluding feet) were treated in our unit using external fixators. A retrospective review of our prospective database was carried out to identify patients with poor regenerate formation requiring bone grafting. Patients with acute fractures, pseudarthrosis of the tibia due to neurofibromatosis and those above the age of eighteen were excluded. An independent observer reviewed the medical records and radiographs. Eleven patients with ages ranging from 2 years 5 months to 17 years 5 months (mean average 9 years 9 months) formed the basis of our study – 3 males and 8 females. Factors that were associated with this complication include age greater than twelve years (10 patients), lack of weight bearing (6 patients), previous fixator (5 patients) and smoking (5 patients). The regenerate was deficient in nine tibial segments and two femoral segments. Six of the deficient tibial regenerates were at a proximal site whilst three were distal. There was no significant difference in length gained between these sites (p Conclusion Delayed consolidation of regenerate in children undergoing treatment of lower limb deformities, though recognised, is under reported. We believe this report will serve as a guide in the consenting process for children undergoing treatment using external fixators.