BONE LENTHENING BY ‘Z’ CORTICOTOMY
Basrah Journal of Surgery,
2004, Volume 10, Issue 2, Pages 59-66
AbstractThis is a prospective study done on 40 patients presented with lower limb length discrepancies between March 1993 and September 2003. After correction of apparent shortening by correcting associated deformities like flexion deformities of the knee, bone lengthening for the remaining true shortening ranging from 3cm – 10.5 cm was done. The "Z" corticotomy involves cutting the cortex in Z manner with preservation of the periostieum and medullar cavity as much as possible, followed by manual distraction.
The advantages of Z corticotomy in comparison to transverse corticotomy or transverse osteotomy are; That there is no need for internal fixation by plate and screws, no need for bone graft to enhance osteogenesis, the chances of mal-alignment of the distracted fragments are minimal as the limbs of the Z – corticotomy maintaining the alignment during the distraction, and the stability of the external fixate is very important for the extent of ontogenesis but this was compensated by doing Z corticotomy.
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