Bone Deformity as a Result of Trauma

Fractures that heal at an odd angle are an example of this. These are called Malunions, or Malunited fractures.

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They do not necessarily cause you any problems in the short term, but can cause problems on the surrounding joints where the 'wear-and-tear' and stress on the joint is not equal across the joint.

 

A Malunion can also give the appearance that the limb is shorter. A Malunion in the leg can therefore cause a limp, and may cause problems with back pain due to the tilt when walking or standing.

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Conditions causing Deformity in Bones

Blount's Disease: May cause bony deformity and bone growth problems.

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Hypophosphatemic Rickets: Can cause Osteomalacia, commonly referred to as 'thinning of the bones' due to the lack of ability to absorb calcium. It can also cause slower bone growth.

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Patients with rickets may have severe 'bowing' of the shin bones. This gives the appearance of being of short stature and may cause problems with the surrounding joints long-term.

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Acondroplasia: Is a condition that causes short stature. The bones affected are the long bones that make up the arm, leg, fingers and toes.

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The patient may have problems achieving their normal daily living activities or may suffer emotional problems due to their lack of height or stature.

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Enchondromatosis: Is the broad title given to a group of conditions that may affect the growth at the ends of bones.

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For example:

• Ollier's disease

• Dyschondroplasia

• Maffucci's Syndrome

• Metaphyseal cChondrodysplasia

• Multiple echondromatosis

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These can affect the growth of the bone during childhood on one or both sides of the same bone. This can cause deformities at the joint itself (on one or both sides of the joint) or may cause shorter limbs.

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Missing Digits

Some babies are born missing digits (fingers and toes) or are missing complete bones.

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Surgery may be able to:

• Improve the function of a hand or foot

• Improve the function of a joint

• Equalise the pressures across a joint.

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How Treatment through Plastic Surgery can help

Plastic surgery in Limb Reconstruction has various aims:

• To improve the function of a joint. 

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• To reconstruct a limb or digit using bone segments from another area of the body.

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• To reconstruct a limb or digit using soft tissues from other areas of the body.

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• To transplant a digit (eg. to transplant a toe to the hand to improve the patients function of the hand).

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• Moving a muscles tendon to another side of a joint to improve the movement or function of a joint.

 

Plastic Surgery may be required to reconstruct the soft tissues. When we talk about “soft tissues” we are referring to skin, fat, muscle and the tendons or ligaments.

 

Plastic Surgery may also involve using bone transferred from one area of your body to another to fill a gap in the bone. This may involve using bony chips usually taken from the part of your hip called the Iliac Crest. This is the area of your hips that stick out at the front, above your groins. The bony chips are then used to fill small gaps in bone. Larger sections of bone may be used to Reconstruct a Limb.

 

This procedure is used in Limb Reconstruction when the amount of lengthening required is more than we can offer by using the frame alone.

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How does the frame Correct a Deformity?

The method is similar to leg lengthening. Using spanners to make tiny movements to the frame the angle of deformity decreases with each day. Your nurse, Mr Khan and physio will teach you (or your carer) how to make the adjustments to your frame.

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