Abstract
Introduction: Limb lengthening using external fixation may be associated with problems such as pin-track infections, poor patient acceptance, muscle transfixation, secondary axial deformity and re-fractures. Intramedullary lengthening nails have been designed to address these issues.
Aim: To review the outcomes for femoral limb lengthening in adults managed by intramedullary lengthening nails.
Materials and Methods: A retrospective review was undertaken for 8 femoral lengthening procedures performed using intra-medullary lengthening nails over a three-year period. The average age of our patients was 34 years and the average duration of follow up was 26.5 months (Range 8 to 40 months). Either an Albizzia nail (5 femurs) or an ISKD (3 femurs) nail was used for the procedure.
Results: Target lengthening was achieved in 7 out of 8 femurs with a average of 38 mm (Range 19 to 70 mm) length gained. The distraction index (length gained per day) was 0.68 on an average and the consolidation index (length of bone consolidating per day) being 0.27 on an average. Premature consolidation in 4 cases, runaway acute lengthening in one patient, prominent metalwork in 4 patients and a bent nail were frequent obstacles and meant multiple visits to theatre.
Conclusions: The desired femoral lengthening is achievable using intra-medullary lengthening nails, thereby avoiding problems associated with callostasis using external fixation methods. It is however, important to counsel patients regarding possibilities of significant obstacles and multiple visits to theatre during the process.
Correspondence should be addressed to BLRS c/o BOA, at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE, England.
