title: Bilateral tibial lengthening over the nail: our experience of 143 cases.
abstract: BACKGROUND
  Using lengthening over an intramedullary nail as a technique for cosmetic purposes improves the individuals' quality of life and provides more satisfactory results due to less external fixator period.
  
  
  METHODS
  This study reports a case series of 143 individuals who underwent bilateral tibial lengthening over an intramedullary nail for cosmetic purposes together with the review of parameters related to the surgery and complications. Level of satisfaction was measured with the standard visual analog scale at least 1 year after removal of external fixator.
  
  
  RESULTS
  In this study, mean (SD) age of patients was 26.6 (7.26) years. 85 (59.4%) participants were male and 58 (40.6%) were female. Mean end lengthening of all individuals was 6.65 cm. The mean external fixator period was 93.7 days. Complication rate was 0.74 per segment but it decreased to 0.45 when pin-tract infection was excluded. Complications were categorized based on Paley et al.'s classification as 129 problems, 85 obstacles and no sequelae. Interestingly, 44 (30.8%) individuals had no problem and obstacle.
  
  
  CONCLUSIONS
  Lengthening over an intramedullary nail provides bone formation in equal quality to that obtained by the conventional Ilizarov method, along with lower rate of complications. The large number of individuals involved in our study is a remarkable benefit which could be used as an appropriate sample to compare results for outcomes and complications.
authors.affiliation: Sina Shemiran Surgery Center, Mahrouzadeh Alley, Shariati St, Tehran, Iran, drmotallebizadeh@gmail.com.
authors.forename: Nader
authors.initials: N
authors.lastname: Motallebi Zadeh
authors.forename: Seyedeh Hamideh
authors.initials: SH
authors.lastname: Mortazavi
authors.forename: Siavash
authors.initials: S
authors.lastname: Khaki
authors.forename: Kazem
authors.initials: K
authors.lastname: Heidari
authors.forename: Ashraf
authors.initials: A
authors.lastname: Karbasi
authors.forename: Sedigheh
authors.initials: S
authors.lastname: Ostad Rahimi
mesh_terms: D000293:Adolescent; D000328:Adult; D001852:Bone Lengthening / Q000295:instrumentation / Q000379:methods*; D001858:Bone Nails; D003357:Cosmetic Techniques / Q000295:instrumentation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators; D007870:Leg Length Inequality / Q000601:surgery*; D008297:Male; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology; D013977:Tibia / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult