Abstract

Ramesh Narula, Sultan Ali Sadiq, Balgopal Nair, Kusum Narula

Introduction: Various methods have been tried in the past for lengthening the shorter limb, e.g., introduction of foreign material or drilling of the metaphysis, obliteration of nutrient foramen, use of shortwave diathermy, lumber sympathectomy, creation of an artificial arteriovenous fistula, and epiphyseal distraction. This study was undertaken to find a simple technique for limb lengthening by a minor surgical procedure, particularly where limb discrepancy is short. Materials and Methods: The experiments were carried out on the right hind leg of 40 rabbits of three months of age in batches of five, each of which was a control. All were anesthetized using Nembutal intra-peritoneally at 40–60 mg/kg of body weight and were then allocated to one of the five experimental groups: A] Control rabbits – anesthesia given but no operation done; B] Vertical periosteal division; C] Vertical periosteal division with periosteal stripping; D] Circular periosteal division; E] Circular periosteal division with periosteal stripping. Before proceeding to operate on the rabbits, the measurements of right and left tibiae of each rabbit were recorded by a vernier caliper from the highest point of tibial tuberosity to the tip of the medial malleolus. After a total duration of 8 weeks from the date of operation, the animals were sacrificed and the tibial lengths were compared from the upper margin of the medial condyle (as this was now the most prominent point) to the tip of the medial malleolus again for comparison. Results: The maximum increase was obtained in the group with circular division along with periosteal stripping, while in the group with vertical division, the minimum increase was obtained. Conclusion: Circumferential periosteal division with stripping is an ideal procedure for minor length discrepancies or for those with limb inequality undergoing other procedures. It is simple and safe and would not require more than a short period in the hospital.