Abstract
Purpose: To present our clinical experience of intramedullary nail application during the consolidation phase after bone lengthening or bone transport.
Material and method: Thirty patients (33 cases) with secondary intramedullary nailing during consolidation phase after callus distraction with an external devise (Ilizarov frame or unilateral system) were evaluated. Docking site nonunion (17 patients), angular deformity or fracture of the lengthened area (8 patients) or intolerance of the external device (5 patients), in combination or not with a delayed distracted callus maturation, were the main reasons for this replacement.
Results: Average follow-up time was 4 (2–12 years). Average external fixation index was 40 days/cm of distraction. Intramedullary infection afterwards the placement of the nail was presented in one case (3,03%), and slight callus length loss in 5 cases (15,2%). Failure of union at the docking site with nail breakage was happened in 1 case (3,03%). In the other patients, ossification was achieved in the lengthened callus area as well as at the docking site, in an average time of 5,9 months from the moment of the nail insertion. All the patients were satisfied after the abstraction of the external devise, while their joint mobility and functionalism were improved rapidly.
Conclusions: The use of intramedullary nailing during consolidation phase after callus distraction, is a treatment option for delayed callus maturation or docking site nonunion, reducing the prolonged use of the external fixator.
The abstracts were prepared by Eleni Koutsoukou. Correspondence should be addressed to him at the Hellenic Association of Orthopaedic Surgery and Traumatology (HAOST), 20, A. Fleming str, 15123 Marousi, Athens, Greece.
