Bone cement has been increasingly used in orthopaedic surgery over the last 50 years. Since Sir John Charnley pioneered the use of polymethylmethacrylate cement in total hip replacements, there have been developments in cementing techniques and an expansion in the number of orthopaedic procedures that use cement. This review covers the perioperative issues surrounding bone cement including storage, cementing techniques and complications. It also discusses specific orthopaedic applications of bone cement and future developments.
A
bstract
Purpose
Circular frames have been the gold standard of treatment for complex deformity corrections and bone loss. However, despite the success of frames, patient satisfaction has been low, and complications are frequent. Most recently, lengthening nails have been used to correct leg length discrepancies. In this article, we review the current trends in deformity correction with emphasis on bone lengthening and present our case examples on the use of lengthening nails for management of complex malunions, non-unions, and a novel use in bone transport.
Materials and methods
A nonsystematic literature review on the topic was performed. Four case examples from our institute, Brighton and Sussex University Hospitals, East Sussex, England, UK, were included.
Results
New techniques based on intramedullary bone lengthening and deformity correction are replacing the conventional external frames. Introduction of lengthening and then nailing and lengthening over a nail techniques paved the way for popularization of the more recent lengthening nails. Lengthening nails have gone through evolution from the first mechanical nails to motorized nails and more recently the magnetic lengthening nails. Two case examples demonstrate successful use of lengthening nails for management of malunion, and two case examples describe novel use in management of non-unions, including the first report in the literature of plate-assisted bone segment transport for the longest defect successfully treated using this novel technique.
Conclusion
With the significant advancement of intramedullary lengthening devices with lower complications rates and higher patient satisfaction, the era of the circular frame may be over.
How to cite this article
Barakat AH, Sayani J, O'Dowd-Booth C,
et al.
Lengthening Nails for Distraction Osteogenesis: A Review of Current Practice and Presentation of Extended Indications. Strategies Trauma Limb Reconstr 2020;15(1):54–61.
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