The Journal of Bone and Joint Surgery, Vol 77, Issue 10 1490-1497, Copyright © 1995 by Journal of Bone and Joint Surgery, Inc
Operative treatment of bone overgrowth in children who have an acquired or congenital amputation
JR Davids, LC Meyer and DW Blackhurst
Shriners Hospitals for Crippled Children, Greenville, South Carolina 29605, USA.
Fifty-three children who were less than thirteen years old were followed
for a median of seven years and ten months (range, two years and nine
months to fourteen years and six months) after operative treatment for
overgrowth of the tibia or humerus after amputation. During the thirty-one
years in which these children were managed, three operative techniques were
used in successive periods. Thus, the fifty-three children could be divided
into three groups: thirty-one who had had a resection and revision, nine in
whom the bone had been capped with a synthetic device, and thirteen in whom
the bone had been capped with an autogenous tricortical bone graft from the
iliac crest. A retrospective review was performed to determine the result
and complications associated with each of these techniques. Survival
analysis revealed that subsequent procedures were performed in twenty-six
(84 per cent) of the thirty-one patients who had had a resection and
revision, in seven of the nine in whom the bone had been capped with a
synthetic device, and in four of the thirteen in whom the bone had been
capped with an autogenous bone graft. The estimated mean survival time
(that is, the time to a subsequent procedure) was five years in the group
that had had the bone capped with an autogenous graft and three years and
six months in the group that had had resection and revision; the difference
is significant (p = 0.003).(ABSTRACT TRUNCATED AT 250 WORDS)
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