title: Secondary intramedullary nailing after distraction osteogenesis: 30 patients followed for 2-12 years.
abstract: BACKGROUND
  There is no consensus about replacement of an external fixator by reamed intramedullary nailing in fracture cases.
  
  
  METHODS
  We evaluated the outcome in 30 patients (33 segments) of secondary intramedullary nailing during the consolidation phase after callus distraction using an external device. The main reasons for nailing were docking site nonunion (17 patients), angular deformity or fracture of the lengthened area (8 patients) or intolerance of the external device (5 patients), in 11 patients combined with a delayed distracted callus maturation. The average follow-up time was 4 (2-12) years.
  
  
  RESULTS
  Intramedullary infection after nailing occurred in 1 case, and slight loss in callus length in 5 cases. Failure of union at the docking site with nail breakage occurred in 1 case. In the other patients, consolidation in the lengthened callus area and also union at the docking site were achieved on average 6 months after nailing.
  
  
  CONCLUSIONS
  We believe that intramedullary nailing during the consolidation phase after bone lengthening or bone transport is a treatment option for delayed callus maturation or docking site nonunion, reducing prolonged use of the external fixator.
authors.affiliation: Department of Orthopaedic Surgery, Patras University Medical Center, Rio-Patras, Greece.
authors.forename: Elias
authors.initials: E
authors.lastname: Lambiris
authors.forename: Andreas
authors.initials: A
authors.lastname: Papadopoulos
authors.forename: Aggeliki
authors.initials: A
authors.lastname: Karabasi
authors.forename: Athanasios
authors.initials: A
authors.lastname: Karageorgos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary; D006801:Humans; D008297:Male; D008875:Middle Aged; D019857:Osteogenesis, Distraction / Q000009:adverse effects*; D011183:Postoperative Complications / Q000601:surgery; D013997:Time Factors