title: Deep intramedullary infection in tibial lengthening over an intramedullary nail.
abstract: Tibial lengthening over an intramedullary (IM) device is associated with a risk of deep intramedullary infection; there is so far no guideline for decision making between early removal and delayed removal of the nail. Tibial lengthening over an intramedullary nail/Rush pin was performed in 118 limb segments (63 patients) from 2004 to 2008 in our institution. Fifty five patients had bilateral tibial lengthening. Ninety nine of the 118 segments went on to healing without infection, while 13 segments developed superficial infection and 6 segments developed deep infection. Among 6 patients with deep infection, 4 patients underwent early removal of the nail when deep infection signs and symptoms occurred and 2 patients underwent delayed removal of the nail at 11 months. The 6 segments with deep infection differed significantly with respect t to the callus pattern (p < 0.05) and density (p = 0.0001) from those without infection and with superficial infection. In this small sugroup, removal of the nail was delayed in two patients as there was visible callus bridging at more than one cortex, and deep infection subsided after local drainage.
authors.affiliation: Institute for Rare Diseases, Department of Orthopaedic Surgery, Korea University Medical Center, Guro Hospital, Seoul, South Korea.
authors.forename: Seung-Ju
authors.initials: SJ
authors.lastname: Kim
authors.forename: Gracia
authors.initials: G
authors.lastname: Cielo Balce
authors.forename: Young-Jae
authors.initials: YJ
authors.lastname: Huh
authors.forename: Sang-Yoon
authors.initials: SY
authors.lastname: Song
authors.forename: Hae-Ryong
authors.initials: HR
authors.lastname: Song
authors.forename: Seung-Ju
authors.initials: SJ
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D001858:Bone Nails; D020878:Device Removal; D005260:Female; D006801:Humans; D018889:Ilizarov Technique; D007870:Leg Length Inequality / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013530:Surgical Wound Infection / Q000628:therapy*; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult