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In a preliminary report on the bactericidal action of pectin, evidence was presented to show that the pectin used," hereinafter referred to as pectin "A", in a p H range of 5.0 to 5.5 and after being subjected to certain thermal conditions, had a bactericidal action on E. coli.' At that time it was not understood to what this action was due. The possibility of a chemical contaminant had been immediately considered but assurance had been given by the producers$ that all pectin was very closely checked for sulphur. lead, arsenic and other metals and that no impurity was then known which could account for the bactericidal action.Further work was done on the action of unautoclaved pectin "A" on E. coli, the effect of autoclaved pectin "A" on a number of other organisms, the action of pectins from other producers5 and the action of 2 derivatives of pectin, namely pectic acid and methyl d-galacturonate. After this work was completed we were informed by the producers1 I of pectin "A" that nickel was present in their product. The nickel is probably picked up during processing when the pectin solution is evaporated on a heated nickel drum. We have confirmed the presence of nickel in the pectin "A" and have tested the bactericidal activity of other samples of this pectin which were found to have varying amounts of nickel. The results of these tests, together with those of the work mentioned above, are presented here.The method used for the bacterial counts was essentially the same as described in the first paper. Escherichia coli was again used and in addition Stafllaylococcus a,uuIyeus, Shligella paradysentem'a Flexner, Pseudoinonas aeruginosa, Em-nia caratowora, a beta hemo-

IntroductionThe FitBone lengthening nail (Orthofix UK) is an intramedullary device licensed for the lengthening of long bones in adults in the UK. It contains a motor powered by electricity transmitted via an induction coil placed underneath the skin. It was developed in Germany two decades ago but uptake in the UK has only started more recently. The aim of this study was to review the first cohort of FitBone lengthening nails in a unit with significant experience of other lengthening nails (including PRECICE and Stryde).Materials & MethodsDemographic, clinical and radiological data was prospectively collected on all FitBone cases starting in February 2022. Accuracy of lengthening rate, patient satisfaction and implant issues were all considered. Complications and learning points were recorded and discussed by the multidisciplinary team involved in the patients care.ResultsEleven lengthening nails were inserted between February and November 2022 (6 right femurs, 5 left femurs). The average patient age was 31 (16–57) with 4 females and 7 males. The average lengthening achieved was 44mm (13– 70) over an average of 59 days (35 to 104). Significant technical issues were encountered in this cohort of patients including slow opening up at osteotomy site (3 requiring speeding up of programme), early consolidation (one requiring re-do osteotomy) and backing out of locking screws (3 out of 11 nails). There were also patient use concerns with difficulty using the motor and the inability to reverse the lengthening without an additional component to the motor.ConclusionsWe present the first UK cohort of patients with femoral lengthening using the FitBone implant and device. We highlight the technical and patient issues encountered during this learning curve and propose solutions to avoid these pitfalls.