Archives of Orthopaedic and Trauma Surgery

, Volume 134, Issue 9, pp 1219–1225 | Cite as

Bilateral tibial lengthening over the nail: our experience of 143 cases

  • Nader Motallebi Zadeh
  • Seyedeh Hamideh Mortazavi
  • Siavash Khaki
  • Kazem Heidari
  • Ashraf Karbasi
  • Sedigheh Ostad Rahimi
Orthopaedic Surgery

Abstract

Introduction

Using lengthening over an intramedullary nail as a technique for cosmetic purposes improves the individuals’ quality of life and provides more satisfactory results due to less external fixator period.

Methods

This study reports a case series of 143 individuals who underwent bilateral tibial lengthening over an intramedullary nail for cosmetic purposes together with the review of parameters related to the surgery and complications. Level of satisfaction was measured with the standard visual analog scale at least 1 year after removal of external fixator.

Results

In this study, mean (SD) age of patients was 26.6 (7.26) years. 85 (59.4 %) participants were male and 58 (40.6 %) were female. Mean end lengthening of all individuals was 6.65 cm. The mean external fixator period was 93.7 days. Complication rate was 0.74 per segment but it decreased to 0.45 when pin-tract infection was excluded. Complications were categorized based on Paley et al.’s classification as 129 problems, 85 obstacles and no sequelae. Interestingly, 44 (30.8 %) individuals had no problem and obstacle.

Conclusions

Lengthening over an intramedullary nail provides bone formation in equal quality to that obtained by the conventional Ilizarov method, along with lower rate of complications. The large number of individuals involved in our study is a remarkable benefit which could be used as an appropriate sample to compare results for outcomes and complications.

Keywords

Lengthening over the nail Tibia Lengthening 

References

  1. 1.
    Kocaoglu M, Eralp L, Kilicoglu O, Burc H, Cakmak M (2004) Complications encountered during lengthening over an intramedullary nail. J Bone Joint Surg 86(11):2406PubMedGoogle Scholar
  2. 2.
    Minty I, Maffulli N, Hughes T, Shaw D, Fixsen J (1994) Radiographic features of limb lengthening in children. Acta Radiol 35(6):555–559PubMedCrossRefGoogle Scholar
  3. 3.
    Saraph V, Roposch A, Zwick EB, Linhart WE (2004) Tibial lengthening over nails in children using modified Ender nails: preliminary results of a new treatment. J Pediatr Orthop B 13(6):383PubMedCrossRefGoogle Scholar
  4. 4.
    Paley D (1990) Problems, obstacles, and complications of limb lengthening by the Ilizarov technique. Clin Orthop Relat Res 250:81PubMedGoogle Scholar
  5. 5.
    Kristiansen LP, Steen H (1999) Lengthening of the tibia over an intramedullary nail, using the llizarov external fixator: major complications and slow consolidation in 9 lengthenings. Acta Orthop 70(3):271–274CrossRefGoogle Scholar
  6. 6.
    Garcia-Cimbrelo E, de la Mano AC, Garcia-Rey E, Cordero J, Marti-Ciruelos R (2002) The intramedullary elongation nail for femoral lengthening. J Bone Joint Surg Br 84(7):971PubMedCrossRefGoogle Scholar
  7. 7.
    Herzenberg JE, Scheufele LL, Paley D, Bechtel R, Tepper S (1994) Knee range of motion in isolated femoral lengthening. Clin Orthop Relat Res 301:49PubMedGoogle Scholar
  8. 8.
    Chen D, Chen J, Jiang Y, Liu F (2011) Tibial lengthening over humeral and tibial intramedullary nails in patients with sequelae of poliomyelitis: a comparative study. Int Orthop 35(6):935–940PubMedCentralPubMedCrossRefGoogle Scholar
  9. 9.
    Guo Q, Zhang T, Zheng Y, Feng S, Ma X, Zhao F (2012) Tibial lengthening over an intramedullary nail in patients with short stature or leg-length discrepancy: a comparative study. Int Orthop 36(1):179–184PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Park HW, Yang KH, Lee KS, Joo SY, Kwak YH, Kim HW (2008) Tibial lengthening over an intramedullary nail with use of the Ilizarov external fixator for idiopathic short stature. J Bone Joint Surg 90(9):1970–1978PubMedCrossRefGoogle Scholar
  11. 11.
    Watanabe K, Tsuchiya H, Sakurakichi K, Yamamoto N, Kabata T, Tomita K (2005) Tibial lengthening over an intramedullary nail. J Orthop Sci 10(5):480–485PubMedCrossRefGoogle Scholar
  12. 12.
    Paley D, Herzenberg JE, Paremain G, Bhave A (1997) Femoral lengthening over an intramedullary nail. A matched-case comparison with Ilizarov femoral lengthening. J Bone Joint Surg 79(10):1464PubMedGoogle Scholar
  13. 13.
    Baumgart R, Betz A, Schweiberer L (1997) A fully implantable motorized intramedullary nail for limb lengthening and bone transport. Clin Orthop Relat Res 343:135–143PubMedCrossRefGoogle Scholar
  14. 14.
    Kim H, Lee SK, Kim KJ, Ahn JH, Choy WS, Kim YI, Koo JY (2009) Tibial lengthening using a reamed type intramedullary nail and an Ilizarov external fixator. Int Orthop 33(3):835–841PubMedCentralPubMedCrossRefGoogle Scholar
  15. 15.
    Jäger M, Bruns H, Küsswetter W, Witt A, Hildebrandt J, Cramer R, Vogel A (1978) Voll implantierbares Distraktionsgerät für die operative Oberschenkelverlängerung. Teil II: Erste klinische Erfahrungen. Biomedizinische Technik/Biomedical. Engineering 23(s1):392–393Google Scholar
  16. 16.
    Krieg AH, Lenze U, Speth BM, Hasler CC (2011) Intramedullary leg lengthening with a motorized nail: indications, challenges, and outcome in 32 patients. Acta Orthop 82(3):344–350PubMedCentralPubMedCrossRefGoogle Scholar
  17. 17.
    Catagni M, Lovisetti L, Guerreschi F, Combi A, Ottaviani G (2005) Cosmetic bilateral leg lengthening: experience of 54 cases. J Bone Joint Surg Br 87(10):1402PubMedCrossRefGoogle Scholar
  18. 18.
    Simpson A, Cole A, Kenwright J (1999) Leg lengthening over an intramedullary nail. J Bone Joint Surg Br 81(6):1041–1045PubMedCrossRefGoogle Scholar
  19. 19.
    Chaudhary M (2008) Limb lengthening over a nail can safely reduce the duration of external fixation. Indian J Orthop 42(3):323PubMedCentralPubMedCrossRefGoogle Scholar
  20. 20.
    Kim S-J, Mandar A, Song S-H, Song H-R (2012) Pitfalls of lengthening over an intramedullary nail in tibia: a consecutive case series. Arch Orthop Trauma Surg 132(2):185–191PubMedCrossRefGoogle Scholar
  21. 21.
    Oh C-W, Song H-R, Roh J-Y, Oh J-K, Min W-K, Kyung H-S, Kim J-W, Kim P-T, Ihn J-C (2008) Bone transport over an intramedullary nail for reconstruction of long bone defects in tibia. Arch Orthop Trauma Surg 128(8):801–808PubMedCrossRefGoogle Scholar
  22. 22.
    Kim S-J, Balce GC, Huh Y-J, Song S-Y, Song H-R (2011) Deep intramedullary infection in tibial lengthening over an intramedullary nail. Acta Orthop Belg 77(4):506PubMedGoogle Scholar
  23. 23.
    Silberg E, Goulet J, Greenfield M (1997) Femoral lengthening: conventional Ilizarov technique compared to lengthening over an intramedullary rod. Orthop Trans 21:71Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Nader Motallebi Zadeh
    • 1
  • Seyedeh Hamideh Mortazavi
    • 1
    • 2
  • Siavash Khaki
    • 1
    • 2
  • Kazem Heidari
    • 3
  • Ashraf Karbasi
    • 1
    • 4
  • Sedigheh Ostad Rahimi
    • 1
  1. 1.Sina Shemiran Surgery CenterTehranIran
  2. 2.School of MedicineTehran University of Medical SciencesTehranIran
  3. 3.Department of Epidemiology and Biostatistics, School of Public HealthTehran University of Medical SciencesTehranIran
  4. 4.Baqiyatallah Research Center of Gastroenterology and LiverBaqiyatallah University of Medical SciencesTehranIran

Personalised recommendations