Limb lengthening and deformity correction with externally controlled motorized intramedullary nails: evaluation of 50 consecutive lengthenings
Background and purpose — Limb lengthening with an intramedullary motorized nail is a relatively new method. We investigated if lengthening nails are reliable constructs for limb lengthening and deformity correction in the femur and the tibia. Patients and methods — 50 lengthenings (34 Precice and 16...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Medical Journals Sweden
2019-01-01
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| Series: | Acta Orthopaedica |
| Online Access: | http://dx.doi.org/10.1080/17453674.2018.1534321 |
| _version_ | 1798018883518464000 |
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| author | Joachim Horn Ivan Hvid Stefan Huhnstock Anne B Breen Harald Steen |
| author_facet | Joachim Horn Ivan Hvid Stefan Huhnstock Anne B Breen Harald Steen |
| author_sort | Joachim Horn |
| collection | DOAJ |
| description | Background and purpose — Limb lengthening with an intramedullary motorized nail is a relatively new method. We investigated if lengthening nails are reliable constructs for limb lengthening and deformity correction in the femur and the tibia. Patients and methods — 50 lengthenings (34 Precice and 16 Fitbone devices) in 47 patients (mean age 23 years [11–61]) with ≥12 months follow-up are included in this study. 30 lengthenings were done due to congenital and 20 because of posttraumatic deformity (21 antegrade femora, 23 retrograde femora, 6 tibiae). Initial deformities included a mean shortening of 42 mm (25–90). In 15 patients, simultaneous axial correction was done using the retrograde nailing technique. Results — The planned amount of lengthening was achieved in all but 2 patients. 5 patients who underwent simultaneous axial correction showed minor residual deformity; unintentionally induced minor deformities were found in the frontal and sagittal plane. The consolidation index was 1.2 months/cm (0.6–2.5) in the femur and 2.5 months/cm (1.6–4.0) in the tibia. 2 femoral fractures occurred in retrograde femoral lengthenings after consolidation due to substantial trauma. There were 8 complications, all of which were correctable by surgery, with no permanent sequelae. Interpretation — Controlled acute axial correction of angular deformities and limb lengthening can be achieved by a motorized intramedullary nail. A thorough preoperative planning and intraoperative control of alignment are required to avoid residual and unintentionally induced deformity. In the femur relatively fast consolidation could be observed, whereas healing was slower in the tibia. |
| first_indexed | 2024-04-11T16:30:30Z |
| format | Article |
| id | doaj.art-88a3d5d97c7a4e37a8e4795871f1c94b |
| institution | Directory Open Access Journal |
| issn | 1745-3674 1745-3682 |
| language | English |
| last_indexed | 2024-04-11T16:30:30Z |
| publishDate | 2019-01-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Orthopaedica |
| spelling | doaj.art-88a3d5d97c7a4e37a8e4795871f1c94b2022-12-22T04:14:02ZengMedical Journals SwedenActa Orthopaedica1745-36741745-36822019-01-01901818710.1080/17453674.2018.15343211534321Limb lengthening and deformity correction with externally controlled motorized intramedullary nails: evaluation of 50 consecutive lengtheningsJoachim Horn0Ivan Hvid1Stefan Huhnstock2Anne B Breen3Harald Steen4Oslo University HospitalOslo University HospitalOslo University HospitalOslo University HospitalOslo University HospitalBackground and purpose — Limb lengthening with an intramedullary motorized nail is a relatively new method. We investigated if lengthening nails are reliable constructs for limb lengthening and deformity correction in the femur and the tibia. Patients and methods — 50 lengthenings (34 Precice and 16 Fitbone devices) in 47 patients (mean age 23 years [11–61]) with ≥12 months follow-up are included in this study. 30 lengthenings were done due to congenital and 20 because of posttraumatic deformity (21 antegrade femora, 23 retrograde femora, 6 tibiae). Initial deformities included a mean shortening of 42 mm (25–90). In 15 patients, simultaneous axial correction was done using the retrograde nailing technique. Results — The planned amount of lengthening was achieved in all but 2 patients. 5 patients who underwent simultaneous axial correction showed minor residual deformity; unintentionally induced minor deformities were found in the frontal and sagittal plane. The consolidation index was 1.2 months/cm (0.6–2.5) in the femur and 2.5 months/cm (1.6–4.0) in the tibia. 2 femoral fractures occurred in retrograde femoral lengthenings after consolidation due to substantial trauma. There were 8 complications, all of which were correctable by surgery, with no permanent sequelae. Interpretation — Controlled acute axial correction of angular deformities and limb lengthening can be achieved by a motorized intramedullary nail. A thorough preoperative planning and intraoperative control of alignment are required to avoid residual and unintentionally induced deformity. In the femur relatively fast consolidation could be observed, whereas healing was slower in the tibia.http://dx.doi.org/10.1080/17453674.2018.1534321 |
| spellingShingle | Joachim Horn Ivan Hvid Stefan Huhnstock Anne B Breen Harald Steen Limb lengthening and deformity correction with externally controlled motorized intramedullary nails: evaluation of 50 consecutive lengthenings Acta Orthopaedica |
| title | Limb lengthening and deformity correction with externally controlled motorized intramedullary nails: evaluation of 50 consecutive lengthenings |
| title_full | Limb lengthening and deformity correction with externally controlled motorized intramedullary nails: evaluation of 50 consecutive lengthenings |
| title_fullStr | Limb lengthening and deformity correction with externally controlled motorized intramedullary nails: evaluation of 50 consecutive lengthenings |
| title_full_unstemmed | Limb lengthening and deformity correction with externally controlled motorized intramedullary nails: evaluation of 50 consecutive lengthenings |
| title_short | Limb lengthening and deformity correction with externally controlled motorized intramedullary nails: evaluation of 50 consecutive lengthenings |
| title_sort | limb lengthening and deformity correction with externally controlled motorized intramedullary nails evaluation of 50 consecutive lengthenings |
| url | http://dx.doi.org/10.1080/17453674.2018.1534321 |
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