title: Tibial lengthening over intramedullary nails: A matched case comparison with Ilizarov tibial lengthening.
abstract: OBJECTIVE
  The purpose of this study was to compare the results and complications of tibial lengthening over an intramedullary nail with treatment using the traditional Ilizarov method.
  
  
  METHODS
  In this matched case study, 16 adult patients underwent 19 tibial lengthening over nails (LON) procedures. For the matched case group, 17 patients who underwent 19 Ilizarov tibial lengthenings were retrospectively matched to the LON group.
  
  
  RESULTS
  The mean external fixation time for the LON group was 2.6 months and for the matched case group was 7.6 months. The mean lengthening amounts for the LON and the matched case groups were 5.2 cm and 4.9 cm, respectively. The radiographic consolidation time in the LON group was 6.6 months and in the matched case group 7.6 months. Using a clinical and radiographic outcome score that was designed for this study, the outcome was determined to be excellent in 17 and good in two patients for the LON group. The outcome was excellent in 14 and good in five patients in the matched case group. The LON group had increased blood loss and increased cost. The LON group had four deep infections; the matched case group did not have any deep infections.
  
  
  CONCLUSIONS
  The outcomes in the LON group were comparable with the outcomes in the matched case group. The LON group had a shorter external fixation time but experienced increased blood loss, increased cost, and four cases of deep infection. The advantage of reducing external fixation treatment time may outweigh these disadvantages in patients who have a healthy soft-tissue envelope.Cite this article: J. E. Herzenberg. Tibial lengthening over intramedullary nails: A matched case comparison with Ilizarov tibial lengthening. Bone Joint Res 2016;5:1-10. doi: 10.1302/2046-3758.51.2000577.
authors.affiliation: Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
authors.forename: R D
authors.initials: RD
authors.lastname: Burghardt
authors.affiliation: Orthopaedic and Traumatological Department, "Luigi Sacco" Hospital, Via GB Grassi 74; 20157 Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Manzotti
authors.affiliation: Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, 2401 West Belvedere Ave, Baltimore MD 21215, USA.
authors.forename: A
authors.initials: A
authors.lastname: Bhave
authors.affiliation: Paley Advanced Limb Lengthening Institute, St. Mary's Hospital, Kimmel Building, 901 45th St., West Palm Beach, FL 33407, USA.
authors.forename: D
authors.initials: D
authors.lastname: Paley
authors.affiliation: International Center for Limb Lengthening and Director, Pediatric Orthopedics, Sinai Hospital of Baltimore, 2401 West Belvedere Ave, Baltimore MD 21215, USA jherzenberg@lifebridgehealth.org.
authors.forename: J E
authors.initials: JE
authors.lastname: Herzenberg
keywords: external fixator; intramedullary nail; lengthening over nail; limb lengthening; tibia