The management of leg-length discrepancy in Ollier's disease with a fully implantable lengthening nail.
Ollier's disease is characterised by severe deformity of the extremities and retarded growth because of multiple enchondromas. For correction of deformity, the Ilizarov method has been used although it has many complications. A 17-year-old boy with Ollier's disease had a limb-length discrepancy of 17.4 cm, with a valgus deformity of the right knee and recurvatum of the femur of 23 degrees . He had undergone three unsuccessful attempts to correct the deformities by using external fixators. We used a fully implantable, motorised, lengthening and correction nail (Fitbone) to achieve full correction of all the deformities without complications. We decided to carry out the procedure in three stages. First, we lengthened the femur by 3.6 cm and the tibia by 4 cm. We then exchanged the femoral nail for a longer implant and achieved a further 6 cm of length. This reduced the shortening to 3.8 cm. When the boy has finished secondary school we will adjust the remaining discrepancy.
Surgical Department University of Munich, Nussbaumstrasse 20, 80336 Munich, Germany. rainer.baumgart@med.uni-muenchen.de
R
R
Baumgart
D
D
Bürklein
S
S
Hinterwimmer
P
P
Thaller
W
W
Mutschler
D000293:Adolescent; D001858:Bone Nails; D004687:Enchondromatosis / Q000150:complications / Q000601:surgery*; D004867:Equipment Design; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D016916:Joint Deformities, Acquired / Q000209:etiology / Q000601:surgery; D007870:Leg Length Inequality / Q000150:complications / Q000601:surgery*; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods; D011859:Radiography; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome