Long-term psychosocial functioning after Ilizarov limb lengthening during childhood 37 patients followed for 2-14 years

• Published in: Acta orthopaedica Vol. 80; no. 6; pp. 704 - 710
• Main Authors: Moraal, Judith M, Elzinga-Plomp, Alda, Jongmans, Marian J, Roermund, Peter M van, Flikweert, Petra E, Castelein, René M, Sinnema, Gerben
• Format: Journal Article
• Language: English
• Published: Basingstoke Taylor & Francis 01.12.2009; Informa Healthcare
• Subjects: Biological and medical sciences; Diseases of the osteoarticular system; Medical sciences; Orthopedic surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Human; Surgical lengthening; Treatment; Surgery; Orthopedics; Child; Long term
• ISSN: 1745-3674; 1745-3682
• DOI: 10.3109/17453670903473024

Background and purpose Few studies have been concerned with the patient's perception of the outcome of limb lengthening. We describe the psychological and social functioning after at least 2 years of follow-up in patients who had had a leg length discrepancy and who had undergone an Ilizarov limb lengthening procedure. Patients and methods Self-esteem and perceived competence were measured in 37 patients (aged 17-30 years) both preoperatively and at a mean follow-up of 7 (2-14) years. At follow-up, health-related quality of life, functioning at school, daily activities, and treatment-related experiences were measured, and also retrospectively for the preoperative period. Results Preoperative and follow-up scores for self-esteem were similar. Overall perceived competence scores at follow-up were comparable to that of a healthy normal population. Patients' perceived athletic competence was lower and their perceived level of behavioral conduct was higher. At follow-up, patients had more positive appraisal of their physical appearance. Most health-related quality of life scores were not significantly different to those of the healthy normal population, apart from a reduced gross motor function, less vitality, and more pain. Patients with a remaining leg length inequality (LLI) of more than 2 cm had lower quality of life scores for gross motor function, sleep, pain, vitality, and depressive feelings. Interpretation At an average of 7 years after an Ilizarov limb lengthening procedure, patients still have physical restraints, but they appear to have normal psychosocial functioning, self-esteem, and perceived competence. These patients have quality of life scores comparable to those of norm groups, apart from a reduced gross motor function, less vitality and more pain. Residual LLI of more than 2 cm remains important even after long-term follow-up; these patients report lower quality of life.