Immediate Limb Lengthening Following Vascular Repair of Iatrogenic Arterial Lesions - A Report of Two Cases.
- 1Department of Orthopaedics, Aalborg University Hospital, Aalborg, Denmark.
Abstract
Vascular injury during distraction osteogenesis is rare but potentially limb-threatening, most often involving the popliteal artery during femoral or tibial osteotomies. Conventional opinion advises delaying distraction post-repair to protect grafts, though evidence is limited. This report presents two such cases, their surgical repair, early distraction initiation, and outcomes, challenging the assumption that prolonged delay is always required. A 16-year-old girl with hypochondroplasia and a 13-year-old boy with post-traumatic limb length discrepancy sustained intraoperative popliteal artery injuries during femoral lengthening. Both underwent urgent autologous great saphenous vein graft repair. Distraction timing was based on graft stability, with close post-operative vascular and radiographic monitoring. Distraction began 9 days post-repair in Case 1 and 14 days post-repair in Case 2, starting at 0.5 mm/day with adjustments for regenerate quality and vascular status. Lengthening goals (6.0 cm and 5.7 cm) were achieved without further vascular compromise. At long-term follow-up (12 years for case 1 and 9.5 years for case 2), no long-term vascular sequelae were reported. Under careful multidisciplinary supervision and vigilant follow-up, distraction osteogenesis can be safely initiated shortly after arterial repair. This individualized approach allows for distraction without needing secondary surgery for re-osteotomy.
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BibTeX
@article{hansen2026immediate,
title = {{Immediate Limb Lengthening Following Vascular Repair of Iatrogenic Arterial Lesions - A Report of Two Cases.}},
author = {Daniel B M Hansen and Mindaugas Mikuzis and Søren Kold},
journal = {Journal of orthopaedic case reports},
year = {2026},
month = nov,
doi = {10.13107/jocr.2026.v16.i11.8450},
url = {https://europepmc.org/article/MED/42997170},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Immediate Limb Lengthening Following Vascular Repair of Iatrogenic Arterial Lesions - A Report of Two Cases.
AU - Daniel B M Hansen
AU - Mindaugas Mikuzis
AU - Søren Kold
PY - 2026
DA - 2026/11/01
JO - Journal of orthopaedic case reports
DO - 10.13107/jocr.2026.v16.i11.8450
UR - https://europepmc.org/article/MED/42997170
AB - Vascular injury during distraction osteogenesis is rare but potentially limb-threatening, most often involving the popliteal artery during femoral or tibial osteotomies. Conventional opinion advises delaying distraction post-repair to protect grafts, though evidence is limited. This report presents two such cases, their surgical repair, early distraction initiation, and outcomes, challenging the assumption that prolonged delay is always required. A 16-year-old girl with hypochondroplasia and a 13-year-old boy with post-traumatic limb length discrepancy sustained intraoperative popliteal artery injuries during femoral lengthening. Both underwent urgent autologous great saphenous vein graft repair. Distraction timing was based on graft stability, with close post-operative vascular and radiographic monitoring. Distraction began 9 days post-repair in Case 1 and 14 days post-repair in Case 2, starting at 0.5 mm/day with adjustments for regenerate quality and vascular status. Lengthening goals (6.0 cm and 5.7 cm) were achieved without further vascular compromise. At long-term follow-up (12 years for case 1 and 9.5 years for case 2), no long-term vascular sequelae were reported. Under careful multidisciplinary supervision and vigilant follow-up, distraction osteogenesis can be safely initiated shortly after arterial repair. This individualized approach allows for distraction without needing secondary surgery for re-osteotomy.
SN - 2250-0685
SN - 2321-3817
ER -