Limb Lengthening and Deformity Correction in Patients with Skeletal Dysplasias

Skeletal dysplasias are a group of disorders affecting the growing skeleton. There are many forms of skeletal dysplasia, each with their own unique characteristics. Limb deformities are a common source of morbidity in this population and affect their quality of life and function. Management of these deformities requires not only a thorough understanding of principles of deformity correction, but also of the unique challenges that patients with skeletal dysplasia pose for the orthopedic surgeon. Care of these patients requires a multidisciplinary, individualized approach as many patients have significant extra-skeletal co-morbidities which need to be appropriately evaluated and managed in addition to correction of their limb deformities. Limb deformities in this population are often complex, with multifocal and multiplanar deformities being frequent. The unique anatomy in each dysplasia as well as the natural history of these conditions, as well as the complex interplay between deformities and their correction on adjacent joints, make deformity correction a formidable task. We outline some of these unique situations, pearls, pitfalls, as well as our approach in correction of deformities in patients with skeletal dysplasias.