Necessity and feasibility of limb length discrepancy correction in congenital vascular malformations in children
DOI:
https://doi.org/10.15574/PS.2020.67.68Keywords:
congenital vascular malformation, limb length discrepancy, surgical treatmentAbstract
Objective: to justify the feasibility and safety of surgical correction of the limb length discrepancy (LLD) in pediatric patients with various forms of congenital vascular malformation (CVM).
Materials and methods. The work is based on the analysis of examination and treatment of 16 patients who were treated at the SI «The Institute of Traumatology and Orthopedics» by NAMS of Ukraine from 2010 to 2019. LLD was established on the basis of clinical and radiological data. Among patients, 12 were treated conservatively; surgical interventions were performed for 4.
Results. LLD was observed in 14 patients due to hypertrophy of the affected limb; due to hypotrophy in 2 patients. Hypertrophy up to 2 cm was in 8 patients; from 2 cm to 3.5 cm was observed in 6 patients. Surgical treatment was used for 4 patients with Klippel–Trenaunay syndrome hypertrophy more than 2 cm; was performed epiphysiodesis with 8-shaped plates. In 3 patients complete LLD correction was achieved in 1.5–2 years, in 1 case the residual LLD of 0.5 cm was preserved. Orthopedic intervention did not affect the course of vascular malformation and did not cause any complications.
Conclusions. It has been established that for patients with CVM the characteristic orthopedic pathology is LLD, which depends on the type of vascular pathology and the age of the patient. The results of surgical treatment of LLD in CVM indicates the feasibility and necessity of surgery in some cases. Surgical treatment of LLD should be justified with due regard for vascular pathology. Epiphysiodesis is a low-trauma and effective way to correct LLD in pediatric patients with CVM.
The research was conducted in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by institution’s the Local Ethics Committee. Informed consent of was obtained from parents of children (or their guardians) for the research.
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