Ilizarov distraction osteogenesis over the preexisting nail for treatment of nonunited femurs with significant shortening

European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie
Wael Azzam, Mohamed El-Sayed

Abstract

Nonunion of the femur with significant shortening with retained intramedullary nail (IMN) is a challenging orthopedic problem. We investigated whether the application of Ilizarov distraction osteogenesis over the preexisting nail can simultaneously achieve union and correct shortening. Thirteen patients with femoral diaphyseal nonunion associated with significant shortening with retained IMN were retrospectively reviewed. All patients were treated by distraction osteogenesis using a circular external fixator over the preexisting nail. The fixator was used to compress or distract the nonunion site and to gradually distract a separate osteotomy to restore limb length. The osteotomy was done percutaneously using the Gigli saw with the nail in situ. The applied surgical technique was bifocal compression distraction in 11 cases, bifocal distraction in one case, and monofocal distraction in one case. Bone healing was achieved in 11 cases (84.6 %) at both the nonunion and the lengthening sites. The mean length gained was 4 cm (range, 3-6 cm). The mean time to fracture union was 4.9 months (range, 4-6 months). The mean knee flexion improved from 86.5° (range, 40°-135°) preoperatively to 109.6° (range, 60°-125°) at final follow-up (p < ...Continue Reading

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Citations

Nov 28, 2017·Journal of Orthopaedic Surgery and Research·Qun ZhangPeifu Tang
Feb 1, 2019·The Bone & Joint Journal·M A CatagniL M Di Giacomo
Aug 18, 2017·The Journal of Bone and Joint Surgery. American Volume·Reggie C HamdyS Robert Rozbruch
Jun 6, 2020·The Orthopedic Clinics of North America·Nickolas Nahm, Louise Reid Boyce Nichols
Mar 26, 2021·The Journal of International Medical Research·Jiang XieAihemaitijiang Yusufu

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