Anwendung motorisierter Verlängerungsmarknägel am wachsenden Skelett

Frommer, Adrien; Rödl, Robert; Gosheger, Georg; Vogt, B

doi:10.1007/s00113-018-0541-4

Cited by 13 publications

(16 citation statements)

References 23 publications

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“…Unrelated to these adverse events, the MHRA also raised concerns about a potentially "inappropriate use in children and adolescents" (British Orthopaedic Association 2021). The MHRA acknowledges a widespread use of PRECICE devices in this age group, but highlights that the nails have not been validated for use in these patient groups (Frommer et al 2018, Nasto et al 2020, Iobst 2020, Iliadis et al 2021, Vogt et al 2021. In our study, 10/27 patients were younger than 18 years old with the youngest patient being 11 years of age.…”

Section: Discussionmentioning

confidence: 99%

Pain, osteolysis, and periosteal reaction are associated with the STRYDE limb lengthening nail: a nationwide cross-sectional study

et al. 2021

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Background and purpose — Observing serious adverse events during treatment with the Precice Stryde bone lengthening nail (NuVasive, San Diego, CA, USA), we conducted a nationwide cross-sectional study to report the prevalence of adverse events from all 30 bone segments in 27 patients treated in Denmark. Patients and methods — Radiographs of all bone segments were evaluated regarding radiographic changes in February 2021. We determined the number of bone segments with late onset of pain and/or radiographically confirmed osteolysis, periosteal reaction, or cortical hypertrophy in the junctional area of the nail. Results — In 30 bone segments of 27 patients we observed radiographic changes in 21/30 segments of 20/27 patients, i.e., 19/30 osteolysis, 12/30 periosteal reaction (most often multi-layered), and 12/30 cortical hypertrophy in the area of the junction between the telescoping nail parts. Late onset of pain was a prominent feature in 8 patients. This is likely to be a prodrome to the bony changes. Discoloration (potential corrosion) at the nail interface was observed in multiple removed nails. 15/30 nails were still at risk of developing complications, i.e., were not yet removed. Interpretation — All Stryde nails should be monitored at regular intervals until removal. Onset of pain at late stages of limb lengthening, i.e., consolidation of the regenerate, should warrant immediate radiographic examination regarding osteolysis, periosteal reaction, and cortical hypertrophy, which may be associated with discoloration (potential corrosion) of the nail. We recommend removal of Stryde implants as early as possible after consolidation of the regenerate.

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Section: Discussionmentioning

confidence: 99%

Pain, osteolysis, and periosteal reaction are associated with the STRYDE limb lengthening nail: a nationwide cross-sectional study

et al. 2021

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“… 1 – 4 The optimal choice of the surgical implant, i.e., intramedullary nail with blocking screws, plate, or external fixator depends on the status of the growth plate, location and severity of the deformity including the need for multiplanar corrections, concomitant limb length discrepancy (LLD), and not least the preference of the surgeon. 5 – 8 …”

Section: B Ackgroundmentioning

confidence: 99%

The Joint Angle Tool for Intraoperative Assessment of Coronal Alignment of the Lower Limb

Abood

Petruskevicius

Vogt

et al. 2020

Strategies in Trauma and Limb Reconstruction

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A bstract Aim Presentation of the joint angle tool (JAT), a low-cost goniometer for intraoperative assessment of the lower limb alignment. Background Intraoperative assessment of coronal alignment is important when performing corrective osteotomies around the knee and ankle, limb lengthening, and trauma surgery. JAT provides surgeons with information about the anatomic and mechanical axes intraoperatively based on true anteroposterior radiographs. Technique JAT consists of pre-printed joint orientation angles of the anatomic and mechanical axis including normal variations on a plastic sheet. It is placed on the screen of the image intensifier after obtaining a true anteroposterior image. The pre-printed joint orientation angles can assist the surgeons intraoperatively in achieving the pre-planned axis correction. Here, its feasibility is demonstrated in four cases. Conclusion and clinical significance JAT is a modified goniometer that allows intraoperative assessment of the mechanical and anatomic axis. JAT is applicable throughout the entire surgical procedure irrespective of the method of internal fixation and may provide additional reassurance of correct alignment. JAT consists of a plastic sheet with printed joint orientation angles and their normal variation. JAT is freely available from profeedback.dk/JAT/JAT.pdf for use and modification according to the Creative Commons license (CC BY-SA 4.0) if this paper is attributed. How to cite this article Abood AA-H, Petruskevicius J, Vogt B, et al. The Joint Angle Tool for Intraoperative Assessment of Coronal Alignment of the Lower Limb. Strategies Trauma Limb Reconstr 2020;15(3):169–173.

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“…To prevent physeal damage in immature patients antegrade ILN implantation is considered to be contraindicated and consequently lengthening is usually carried out using external fixators (Wagner et al 2017, Frommer et al 2018. In patients with preexisting ankle and hindfoot fusion and concomitant closure of the distal tibial growth plate, the retrograde approach allows the use of a tibial ILN and eliminates the need for external fixators.…”

Section: Discussionmentioning

confidence: 99%

“…In patients with preexisting ankle and hindfoot fusion and concomitant closure of the distal tibial growth plate, the retrograde approach allows the use of a tibial ILN and eliminates the need for external fixators. The distraction goal should be defined on the basis of the predicted LLD at skeletal maturity when conducting leg lengthening in immature patients with a closed distal tibial physis (Frommer et al 2018). In patients with fused ankle and hindfoot the goal of the treatment should not be exact LLD equalization.…”

Section: Discussionmentioning

confidence: 99%

“…In patients with preexisting ankle and hindfoot fusion a retrograde approach provides an alternative technique for tibial nail insertion. Approach-associated affections of the knee joint like anterior knee pain (Rothberg et al 2019) and-in immature patients-damage to the proximal tibial growth plate (Wagner et al 2017, Frommer et al 2018) can be avoided. Despite these potential advantages, the use of a retrograde tibial nailing approach and distal tibial osteotomy in patients with preexisting ankle and hindfoot fusion has not been evaluated so far.…”

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confidence: 99%

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Tibial lengthening using a retrograde magnetically driven intramedullary lengthening device in 10 patients with preexisting ankle and hindfoot fusion

Vogt¹,

Roedl²,

Gosheger

et al. 2020

Acta Orthopaedica

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Background and purpose — Motorized intramedullary lengthening nails (ILNs) have been developed as an alternative to external fixators for long bone lengthening. The antegrade approach represents the standard method for tibial ILN insertion. In patients with preexisting ankle and hindfoot fusion a retrograde approach provides an alternative technique that has not been evaluated so far. We report the outcome of this method in 10 patients. Patients and methods — This retrospective study included 10 patients (mean age 18 years [13–25]) with preexisting ankle and hindfoot fusion who underwent tibial lengthening with a retrograde ILN (PRECICE). The mean leg length discrepancy (LLD) was 58 mm (36–80). The underlying conditions were congenital (n = 9) and post tumor resection (n = 1). The main outcome measures were: ILN reliability, distraction achieved, distraction index (DIX), time to bone healing, consolidation index (CIX), complications, and functional results. Results — All patients achieved the goal of lengthening (mean 48 mm [26–80]). Average DIX was 0.6 mm/day (0.5–0.7) and mean CIX was 44 days/cm (26–60). Delayed consolidation occurred in 2 patients and healed after ILN dynamization or nail exchange with grafting. Toe contractures in 2 other patients were resolved with physiotherapy or tenotomy. Until last follow-up (mean 18 months [12–30]) no true complications were encountered, knee motion remained unaffected, and full osseous consolidation occurred in all patients. Interpretation — In patients with LLD and preexisting ankle and hindfoot fusion distal tibial lengthening using a retrograde ILN is a reliable alternative to the standard approach with equivalent bone healing potential and low complication rates leaving the knee unaffected.

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Anwendung motorisierter Verlängerungsmarknägel am wachsenden Skelett

Cited by 13 publications

References 23 publications

Pain, osteolysis, and periosteal reaction are associated with the STRYDE limb lengthening nail: a nationwide cross-sectional study

Pain, osteolysis, and periosteal reaction are associated with the STRYDE limb lengthening nail: a nationwide cross-sectional study

The Joint Angle Tool for Intraoperative Assessment of Coronal Alignment of the Lower Limb

Tibial lengthening using a retrograde magnetically driven intramedullary lengthening device in 10 patients with preexisting ankle and hindfoot fusion

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