Extensive Bone Lengthening for a Patient with Linear Morphea
Localized scleroderma, also known as morphea, is a rare condition characterized by progressive sclerosis of the skin and associated atrophy of the underlying tissues. The linear type of localized scleroderma is the most frequent form in childhood, usually affecting unilateral extremities. Fibroscler...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Case Reports in Orthopedics |
| Online Access: | http://dx.doi.org/10.1155/2018/4535804 |
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| author | Kenichi Mishima Hiroshi Kitoh Masaki Matsushita Tadashi Nagata Yasunari Kamiya Naoki Ishiguro |
| author_facet | Kenichi Mishima Hiroshi Kitoh Masaki Matsushita Tadashi Nagata Yasunari Kamiya Naoki Ishiguro |
| author_sort | Kenichi Mishima |
| collection | DOAJ |
| description | Localized scleroderma, also known as morphea, is a rare condition characterized by progressive sclerosis of the skin and associated atrophy of the underlying tissues. The linear type of localized scleroderma is the most frequent form in childhood, usually affecting unilateral extremities. Fibrosclerosis of the fasciae and muscles can spread across joints and impair the range of motion of the joint. Dysplastic and/or atrophic bones of the affected lower extremity can lead to clinically significant leg length discrepancy (LLD). Limb reconstruction surgery has rarely been indicated for LLD in patients with linear morphea. We report on a case of extensive bone lengthening for appreciable LLD in a pediatric patient with linear morphea. A Japanese girl with linear morphea underwent staged simultaneous lengthening of the femur and tibia twice at seven and eleven years of age using a unilateral external fixator. A healing index exceeded 100 days/cm except for the first femoral lengthening that was complicated by regenerate fracture. At the final follow-up, LLD of 38 mm remained, but she could walk independently without a brace or a crutch. Due to soft tissue tightness and poor regenerative ability in the affected limb, cautions should be taken to prevent regenerate fracture and/or malalignment of the limb. |
| format | Article |
| id | doaj-art-a3ca27954c4d48dca79cf4762d100dac |
| institution | Kabale University |
| issn | 2090-6749 2090-6757 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Orthopedics |
| spelling | doaj-art-a3ca27954c4d48dca79cf4762d100dac2025-02-03T05:58:37ZengWileyCase Reports in Orthopedics2090-67492090-67572018-01-01201810.1155/2018/45358044535804Extensive Bone Lengthening for a Patient with Linear MorpheaKenichi Mishima0Hiroshi Kitoh1Masaki Matsushita2Tadashi Nagata3Yasunari Kamiya4Naoki Ishiguro5Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi 466-8550, JapanDepartment of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi 466-8550, JapanDepartment of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi 466-8550, JapanDepartment of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi 466-8550, JapanDepartment of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi 466-8550, JapanDepartment of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi 466-8550, JapanLocalized scleroderma, also known as morphea, is a rare condition characterized by progressive sclerosis of the skin and associated atrophy of the underlying tissues. The linear type of localized scleroderma is the most frequent form in childhood, usually affecting unilateral extremities. Fibrosclerosis of the fasciae and muscles can spread across joints and impair the range of motion of the joint. Dysplastic and/or atrophic bones of the affected lower extremity can lead to clinically significant leg length discrepancy (LLD). Limb reconstruction surgery has rarely been indicated for LLD in patients with linear morphea. We report on a case of extensive bone lengthening for appreciable LLD in a pediatric patient with linear morphea. A Japanese girl with linear morphea underwent staged simultaneous lengthening of the femur and tibia twice at seven and eleven years of age using a unilateral external fixator. A healing index exceeded 100 days/cm except for the first femoral lengthening that was complicated by regenerate fracture. At the final follow-up, LLD of 38 mm remained, but she could walk independently without a brace or a crutch. Due to soft tissue tightness and poor regenerative ability in the affected limb, cautions should be taken to prevent regenerate fracture and/or malalignment of the limb.http://dx.doi.org/10.1155/2018/4535804 |
| spellingShingle | Kenichi Mishima Hiroshi Kitoh Masaki Matsushita Tadashi Nagata Yasunari Kamiya Naoki Ishiguro Extensive Bone Lengthening for a Patient with Linear Morphea Case Reports in Orthopedics |
| title | Extensive Bone Lengthening for a Patient with Linear Morphea |
| title_full | Extensive Bone Lengthening for a Patient with Linear Morphea |
| title_fullStr | Extensive Bone Lengthening for a Patient with Linear Morphea |
| title_full_unstemmed | Extensive Bone Lengthening for a Patient with Linear Morphea |
| title_short | Extensive Bone Lengthening for a Patient with Linear Morphea |
| title_sort | extensive bone lengthening for a patient with linear morphea |
| url | http://dx.doi.org/10.1155/2018/4535804 |
| work_keys_str_mv | AT kenichimishima extensivebonelengtheningforapatientwithlinearmorphea AT hiroshikitoh extensivebonelengtheningforapatientwithlinearmorphea AT masakimatsushita extensivebonelengtheningforapatientwithlinearmorphea AT tadashinagata extensivebonelengtheningforapatientwithlinearmorphea AT yasunarikamiya extensivebonelengtheningforapatientwithlinearmorphea AT naokiishiguro extensivebonelengtheningforapatientwithlinearmorphea |