Article

Parents of children suffering from disproportionate short stature due to
achondroplasia may wish to have surgical leg lengthening carried out for the child. The aim is not to increase height, but rather to achieve physiological
proportions in the body. In a systematic review of the literature on the topic
dating from the last 20 years, the surgical approaches used for this purpose were
analyzed in accordance with the Preferred reporting items for systematic reviews
and meta-analyses (PRISMA) criteria. Twelve studies show that to date,
involvement of the child in decision-making at the start of treatment has been
expected and that it is recommended from the age of 12. In highly heterogeneous
patient groups, with varying factors involved and different techniques being
used, lengthening (often by more than 10 cm) is described. High complication
rates are reported, with many setbacks often requiring repeat surgery. Using
PALEY'S multiplier method, the expected standing height, sitting height, and leg
length can be predicted and an individualized treatment approach can be planned
and operative procedures could be started in early childhood as PERETTI suggests.
As the patients are unable to be involved in decision-making as young children,
these data may provide a basis for offering differentiated advice to parents, who
usually consult a pediatric orthopedist at a very early stage in the child's life.

Langue : ANGLAIS