From: http://www.wheelessonline.com/ortho/complications_of_limb_lengthening_a_...
* Dahl MT. Gulli B. Berg T. Clinical Orthopaedics & Related Research. (301):10-8, 1994 Apr. Major complication rates during limb lengthening were plotted in a consecutive series to produce a learning curve. All unwanted events during Á and after treatment were considered complications, and graded as minor, Â serious, and severe. All serious and severe complications were considered major. A novel system was used to classify the preoperative severity of each deformity. One-hundred ten patients had 140 bone segments lengthened between 2.2 cm and 10.5 cm, with a mean of 4.4 cm. Three methods were used in lengthening: the Wagner method in 22 patients, the DeBastiani method in 34 patients, and the Ilizarov method in 84 patients. Ninety-eight complications categorized as serious or severe occurred, for a total major complication rate of 72%. The percentage of major complications began to drop after 30 lengthenings to a current rate of 25%. Major complications were frequent in patients with more severe deformities, particularly in * those whose cases occurred early in the series. Bone healing complications were high (72%) in the Wagner segments but were also high (80%) in the first ten patients treated with the DeBastiani technique. The first ten Ilizarov patients, who were treated later in the series, had a 40% rate of Á bone-healing complications. The current rate of major complications is 13% for those patients treated with DeBastiani's method and 33% for those patients treated with Ilizarov's method. This difference in complication rates appears to relate to the severity of the deformity, rather than the device used. There was a significant decrease in complications as experience was gained. Directed formal study and surgical instruction should help diminish these complications.
[PFFD Editors Notes:]
Questions I have
a) Did the complication rate decrease because of knowledge of which patients to treat and which ones not to treat? complication rates appears to relate to the severity of the deformity E.g. were more severely deformed patients then recommended away from lengthening treatment in the later part of the study?
b) What was chart of "total amount lengthened" vs "patient enroled date"