language : USA-UK Français Japanese Espana China

Indications :

UNILATERAL LENGTHENING

Unilateral lengthening addresses trauma, hereditary or congenital diseases involving the femur, tibia and humerus.

STATURE: DWARFISM AND CONGENITAL SHORT STATURE

Dwarfism is below the standard stature of major part of the 'normal' population.

The range of normal population is limited by +3SD (Standard Deviations) and - 3SD which represents 99.5% of the population, or +2SD and - 2SD (95% of the population).

The population of dwarfs is far below this range. People who are higher than dwarfs, but shorter than the 'normal' population, are considered as 'Short Stature' and 'Cosmetic' candidates to lengthening.

 

STATURE

Average and Standard Deviation (cm)

Female

Male

Standard Non-Dwarf population

Average

163

176

-1 SD (68% of the population is > this stature)

160

172.5

-2SD  (95% of the population is > this stature)

156

169

- 3SD  (99.7% of the population is > this stature)

153

166

Dwarfism

+2SD  (95% of the dwarf population is < this stature)

136

142

Average

125

130

 

COSMETIC SURGERY

In cosmetic surgery, there is generally no pathology. This needs to be checked before any operation. Associated problems are generally 'O' or 'X' shaped legs.

BONE DISEASES AND MALALIGNMENTS

At the bone level, anomalies can be observed related to the bony 'architecture' (e.g. alignment/axis deformation like 'O' or 'X' shaped legs), the length (unilateral discrepancy, or bilateral shortening like dwarfism and congenital short stature), and structural or quality lesions like bone dysplasia or orphan diseases. At the joint level, axis deviations can exist, but also larger deformities due to absence (complete or incomplete) of joints, at the hip level (e.g. in PFFD, Proximal Femoral Focal Deficiency), at the knee level (e.g. absence of cruciate ligaments), at the ankle, or at the foot. Often soft tissue lesions are associated.

Dr. Guichet developed many techniques allowing sometime impressive treatments, for example for lengthening (Guichet® Nail, corrections with 3D lengthening nails, etc.), or for rebuilding, during growth, missing knee ligaments.

Sometimes, associated deformations are noted and form individualized diseases (PFFD or congenital short femur, fibular hemimelia or tibia agenesis, congenital club-foot, recurrent club-foot, etc.). Sometimes shortenings are very large, reaching 30 cm (12 inches) 1 ! At the foot level, some pathology are frequently noted like the metatarsus adductus, the hallux valgus or the flat foot.