Use of internal lengthening nails in post-traumatic sequelae

Alrabai, Hamza M.; Gesheff, Martin G.; Conway, Janet D.

doi:10.1007/s00264-017-3466-6

Cited by 19 publications

(8 citation statements)

References 44 publications

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“…Lengthening with the motorized Fitbone ® nail is an acceptable and predictable solution to trauma-related LLD that can also be associated with axial and rotational deformity. The presented results are consistent with previous publications [7,11,[20][21][22][23].…”

Section: Discussionsupporting

confidence: 93%

Bone Lengthening with a Motorized Intramedullary Nail in 34 Patients with Posttraumatic Limb Length Discrepancies

Teulières

Langlais

Gauzy

et al. 2021

JCM

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The Fitbone® motorized nail system has been used to correct limb length discrepancies (LLD) for several years. This study focuses on its application in posttraumatic limb lengthening surgery, its outcome and challenges. Materials and methods: A prospective, single center study was conducted between 2010 and 2019 in patients treated with motorized lengthening nails. The inclusion criteria were symptomatic LLD of 20 mm or more. An imaging analysis was done using TraumaCad® software (Brainlab AG, Munich, Germany) to compare frontal alignment angles and limb length discrepancy (LLD) on preoperative and latest follow-up radiographs of the lower limbs. Results: Thirty-four patients were included with a mean age of 28.8 ± 9.7 years, a mean follow-up of 27.8 ± 13 months and a mean hospital stay of 4.4 ± 1.7 days. The mean LLD was 44 ± 18 mm in 29 femoral and 32 ± 8 mm in 4 tibial cases, which was reduced to less than 10 mm in 25/34 (74%) patients. The mean healing index was 84.6 ± 62.5 days/cm for femurs and 92 ± 38.6 days/cm for tibias. The mean time to resume full weight-bearing without walking aids was 226 days ± 133. There was no significant difference between preoperative and final follow-up alignment angles and range of motion. The mechanical lateral distal femoral angle (mLDFA) was corrected in the subgroup of 10 LLD patients with varus deformity of the femur (preoperative 95.7° (±5.0) vs. postoperative 91.5° (±3.4), p = 0.008). According to Paley’s classification, there were 14 problems, 10 obstacles and 2 complications. Discussion: Six instances of locking screw pull out, often requiring reoperation, raise the question of whether a more systematic use of blocking screws that provide greater stability might be indicated. Lack of compliance can lead to poor outcomes, patient selection in posttraumatic LLD patients is therefore important. Conclusion: Limb lengthening with a motorized lengthening nail for posttraumatic LLD is a relatively safe and reliable procedure. Full patient compliance is crucial. In-depth knowledge of lengthening and deformity correction techniques is essential to prevent and manage complications.

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Section: Discussionsupporting

confidence: 93%

Bone Lengthening with a Motorized Intramedullary Nail in 34 Patients with Posttraumatic Limb Length Discrepancies

Teulières

Langlais

Gauzy

et al. 2021

JCM

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“…Masquelet is generally better accepted and can be used in less compliant patients given that the prolonged use of an external frame is avoided [ 3 ]. While relatively new bone transport techniques utilizing internal lengthening nails are showing promising results, these techniques have limited utility for large defects due to limitations in the maximum amount of distraction that the available implants can achieve (i.e., the magnetically actuated lengthening PRECICE® nail (Nuvasive, Aliso Viego, CA, USA) allows for 8 cm of maximum distraction) [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Management of twenty centimeter segmental bone defect of femoral shaft secondary to infected non-union of fracture using masquelet technique: A case report

Kubes

Friedman

Pyle

et al. 2021

International Journal of Surgery Case Reports

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Introduction Segmental bone loss is a challenging condition to manage, and some of the techniques employed are difficult for patients to tolerate and involve lengthy treatment and rehabilitation times. The Masquelet technique is a two-stage bone grafting technique used to treat segmental bone defects. The technique has primarily been described for bone defects averaging 5.5 cm in length. This technique's advantages include protection against autograft resorption, relative maintenance of graft position, and prevention of soft-tissue interposition. We present a case report of a male who achieved successful bone defect union utilizing the Masquelet technique for a right femoral shaft infected non-union with a resultant 20 cm bone defect. Case report This is a case report of a 28-year old male who presented to our clinic for evaluation and treatment for a segmental bone defect secondary to a right femur fracture with non-union after infection. The patient had been in a motor vehicle collision. Our patient was interested in limb salvage surgery and declined bone transport. Given the significant size of his defect, we opted to treat him utilizing the Masquelet technique. He went on to have a successful union of his defect with associated increased subjective quality of life and functionality. Conclusion The Masquelet technique is a useful limb salvage treatment for patients with segmental bone defects, including large defects of 20 cm in length.

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“…After osteotomy, a controlled progressive elongation is achieved by means of interaction between the external remote controller and the magnet inside the nail [38] . Non-invasive lengthening nails are currently available for femur and tibia and they are successfully employed for distraction osteogenesis in the treatment of limb length discrepancy and in deformity correction in congenital or posttraumatic conditions or oncologic reconstructions [39,40] . In particular, the association of intramedullary lengthening nail with bridging plate fixation allows the reconstruction of posttraumatic bone defects [41] .…”

Section: Distraction Osteogenesismentioning

confidence: 99%

Regenerative medicine in orthopaedic surgery

2021

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Regenerative medicine includes the use of technologies aimed at repairing or replacing damaged cells, tissues and organs, in order to restore their structure and function. The clinical indications for the use of regenerative medicine in orthopaedic surgery are degenerative diseases (arthritis, aseptic necrosis, osteochondritis), posttraumatic conditions (non-union) and osteoarticular segmental bone loss. The objective of tissue regeneration in orthopaedic surgery can be achieved with minimally invasive techniques or using open surgery with the application of biological or synthetic scaffolds, autologous mesenchymal stem cells, growth factors or specific surgical techniques and new-generation surgical devices. Three-dimensional bioprinting, the new frontier of tissue engineering, is a promising technology for regenerative medicine in orthopaedic surgery. In the present review, all the different techniques of bone tissue regeneration will be described with the aim of highlighting their evidence-based effectiveness and trying to define their specific role in different indications.

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Use of internal lengthening nails in post-traumatic sequelae

Cited by 19 publications

References 44 publications

Bone Lengthening with a Motorized Intramedullary Nail in 34 Patients with Posttraumatic Limb Length Discrepancies

Bone Lengthening with a Motorized Intramedullary Nail in 34 Patients with Posttraumatic Limb Length Discrepancies

Management of twenty centimeter segmental bone defect of femoral shaft secondary to infected non-union of fracture using masquelet technique: A case report

Regenerative medicine in orthopaedic surgery

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