Limb Reconstruction

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Guided Growth Eight Plates

Pin Site Management

Single Entry Percutaneous Epiphysiodesis

Limb Reconstruction

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The Paediatric Limb Reconstruction service in Our Lady’s Childrens Hospital Crumlin is led by Consultants, nurses and physiotherapists who are experts in their field.

Conditions most commonly treated are:

• Congenital bone dysplasias : Tibial and Fibular Hemimelia;Proximal femoral focal deficiency ( P.F.F.D.)

• Congenital deformities of the foot / relapsed Congenital Talipes Equinovarus

• Limb shortening and limb deformity in association with acquired generalised bone conditions

• Fractures with  non-union

• Reconstruction following malignant tumour removal.

• Treatment of post traumatic limb deformity

• Complex trauma fractures requiring external fixation to correct

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We use methods of Guided Growth (pedi / eight plate) and Epiphysiodesis to managed growing limb conditions also

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Knock Knees or Bowed legs

In normal skeletal growth, limbs are equal in length and are properly aligned from the hips to the ankles. Sometimes however, congenital abnormalities, infection, injury or other conditions can cause long bones of the leg) e.g. tibia, femur) to grow out of alignment.

This malalignment may often result in joint deformities of the leg known as valgus (knock knees) or varus (bowed legs) deformities. In these situations, normal use of the leg is impaired and walking or running may be painful. Unfortunately, bracing is not effective in the management of these conditions. The correction of limb deformities requires one of two surgical options: either an osteotomy or the minimally invasive hemi-epiphysiodesis plating procedure. Details here

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Single Entry Percutaneus Epiphysiodesis

This is a procedure on the epiphyseal (growth) plate in one limb to slow down the growth of a specific bone. Usually, it is carried out if one leg is a different length to the other in order to equalise limb lengths.

During childhood and adolescence, the long bones- femur or tibia and fibula-are each made up of a shaft of bone (diaphysis) and end parts (epiphyses). The epiphyses are separated from the shaft by a layer of cartilage called the epiphyseal or growth plate.

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When limbs growth during childhood and adolescence, the epiphyseal plates absorb calcium and develop into bone. By adulthood the plates have been replace by bone.

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During an operation, which is carried out under general anaesthetic, a procedure is done to damage to growing area of the plate in order to slow the growth of the relevant bone. The resulting benefits are seen between then and the child finishing growth.  Link

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The service encompasses multiple reconstructive orthopaedic techniques. Limb lengthening and limb deformity correction with internal fixation such as nailing and external fixation are carried out.

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External fixation may be either The Ilizarov Method  using Taylor Spatial frame (T.S.F).  or L.R.S. Rail systems.

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Internal fixation methods include use of the PRECICE Nail.

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