Leg lengthening with a motorized nail in adolescents : an alternative to external fixators?
Leg lengthening by external fixation is associated with various difficulties. We evaluated eight adolescent patients who underwent leg lengthening with a motorized intramedullary lengthening device. We asked whether this method could reduce the time of hospitalization and rehabilitation and whether the incidence of complications commonly associated with external fixators could be reduced. We compared our preliminary results with those from other reports, with a focus on leg length achieved, time of rehabilitation, and rate of complications. The average leg-length discrepancy was 3.8 cm (range, 3-5 cm). The average lengthening distance was 3.8 cm (range, 2.9-4.7 cm). In six patients, leg lengthening was combined with successful correction of the mechanical axis alignment. The consolidation index averaged 26 days/cm (range, 19-41 days/cm). The average hospital stay was 9.6 days. No bone or soft tissue infections were observed. In comparison to other studies (1.0-2.8 complications/patient), our results suggest that the difficulties commonly associated with external fixators can be reduced with this method. It also allows good angular correction in patients with mechanical axis deviation. These features combined with a short time of hospitalization and rehabilitation make it a promising procedure for limb lengthening.


METHODS
Level IV Therapeutic study.
Krieg
Andreas H
AH
Pediatric Orthopaedic Department, University Children's Hospital, PO Box Römergasse 8, 4005 Basel, Switzerland. andreas.krieg@ukbb.ch
Speth
Bernhard M
BM
Foster
Bruce K
BK
D000293:Adolescent; D001858:Bone Nails; D011211:Electric Power Supplies; D004867:Equipment Design; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D016268:Internal Fixators; D007870:Leg Length Inequality / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D011446:Prospective Studies; D011859:Radiography; D020127:Recovery of Function; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome