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Leg Lengthening With a Motorized Nail in Adolescents

An Alternative to External Fixators?

  • Original Article
  • Pediatrics
  • Published:
Clinical Orthopaedics and Related Research

Abstract

Leg lengthening by external fixation is associated with various difficulties. We evaluated eight adolescent patients who underwent leg lengthening with a motorized intramedullary lengthening device. We asked whether this method could reduce the time of hospitalization and rehabilitation and whether the incidence of complications commonly associated with external fixators could be reduced. We compared our preliminary results with those from other reports, with a focus on leg length achieved, time of rehabilitation, and rate of complications. The average leg-length discrepancy was 3.8 cm (range, 3–5 cm). The average lengthening distance was 3.8 cm (range, 2.9–4.7 cm). In six patients, leg lengthening was combined with successful correction of the mechanical axis alignment. The consolidation index averaged 26 days/cm (range, 19–41 days/cm). The average hospital stay was 9.6 days. No bone or soft tissue infections were observed. In comparison to other studies (1.0–2.8 complications/patient), our results suggest that the difficulties commonly associated with external fixators can be reduced with this method. It also allows good angular correction in patients with mechanical axis deviation. These features combined with a short time of hospitalization and rehabilitation make it a promising procedure for limb lengthening.

Level of Evidence: Level IV Therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Authors and Affiliations

  1. Pediatric Orthopaedic Department, University Children’s Hospital, PO Box Römergasse 8, 4005, Basel, Switzerland

    Andreas H. Krieg MD & Bernhard M. Speth MD

  2. Department of Orthopaedics, Women’s and Children’s Hospital, North Adelaide, South Australia

    Bruce K. Foster MBBS, MD

Authors
  1. Andreas H. Krieg MD
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  2. Bernhard M. Speth MD
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  3. Bruce K. Foster MBBS, MD
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Correspondence to Andreas H. Krieg MD.

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Each author certifies that he has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent was obtained.

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Krieg, A.H., Speth, B.M. & Foster, B.K. Leg Lengthening With a Motorized Nail in Adolescents. Clin Orthop Relat Res 466, 189–197 (2008). https://doi.org/10.1007/s11999-007-0040-3

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  • DOI: https://doi.org/10.1007/s11999-007-0040-3

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