Leg lengthening using intramedullay skeletal kinetic distractor: results of 57 consecutive applications

Injury
Mohamed KenaweyStefan Hankemeier

Abstract

Mechanically activated intramedullary lengthening nails are advantageous over external fixator. However, difficulties with the control of the distraction rate are the main drawbacks, which may in turn cause insufficient bone regenerate. A total of 57 lengthening procedures were performed using intramedullary skeletal kinetic distractor (ISKD) nail in 53 patients (femoral = 45 and tibial = 12). Average length gain was 4.3 ± 1.6 cm. The cause of shortening was post-traumatic (n = 33), congenital (n = 20), post-tumour resection (n = 1), cosmetic femoral lengthening (n = 2) and post-correction of distal femoral varus deformity (n = 1). The desired lengthening was achieved in all patients. The mean follow-up period was 23 ± 12 months. The healing index for patients with normal bone healing was 1.2 ± 0.32 months/cm. Complications in femoral lengthening were superficial wound infection (n = 1), premature consolidation (n = 4) and insufficient bone regenerate (n = 11), while in the tibial lengthening, two developed equinus contractures,one had compartment syndrome following implantation of the nail and one insufficient bone regenerate.Furthermore, nine runaway nails and three non-distracting nails were present in the femoral lengthenin...Continue Reading

References

Jul 12, 2005·Operative Orthopädie und Traumatologie·Stefan HankemeierChristian Krettek
Jul 2, 2009·The Journal of Bone and Joint Surgery. British Volume·A H W R SimpsonG Keenan

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