Outcome and challenges of management of limb length discrepancy using linear rail system

Background: Management of limb length discrepancy (LLD) is a rewarding procedure though time consuming and is associated with some challenges. The aim of this study was to determine the time it takes for complete treatment of LLD from the time of osteotomy, with respect to the length of the LLD, method used, types of bone involved, pathologies and site of osteotomy.

Method: All consecutive patients with LLD more than 4 cm who consented during the study period were recruited into the study. Data obtained was analysed using SPSS version 19.

Results: Twenty-three patients were recruited into the study, 18 males and 5 females. The mean age was 36.35 ± 7.87 years, ranged 25–50 years. The mean LLD corrected was 7.30 ± 1.19 cm (range 5 cm to 9 cm). There were 12 tibia (52.2%) and 11 femur (47.8%), infective pathologies were 15 (65.2%), while non infective pathologies were 8 (34.8%). Bone transport was done in 8 (34.8%) patients while bone lengthening was done in 15 (65.2%) patients. Diaphyseal osteotomy was done in 13 (56.5%) patients while metaphyseal osteotomy was done in 10 (43.5%) patients. The mean time from osteotomy to removal of LRS was 264.39 ± 53.65 days. The complications noticed were pin tract infections, residual LLD, angulation of regenerate, and delayed union at ducking site.

Conclusion: LRS produces good outcome in the management of LLD for both infective and non-infective pathologies, with osteotomy done at metaphysis or diaphysis using either bone transport or bone lengthening methods.