RESEARCH PROGRESS IN LOWER LIMB LENGTHENING BY INTRAMEDULLARY NAIL_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 LIMeng ¹ , ZENGPing ¹ , QINGSihe ²

1. Department of Orthopaedics, Lanzhou General Hospital, Lanzhou Guansu, 730050, P. R. China;
2. Department of Orthopaedics, Rehabilitation Hospital of the National Research Center for Rehabilitation Technical Aids;

Corresponding author：

LIMeng, Email: lilionli@126.com

Keywords：

Intramedullary nail; Limb lengthening; lower extremity

DOI：

10.7507/1002-1892.20160129

Video：

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Objective To summarize the research progress in the lower limb lengthening by intramedullary nail. Methods The domestic and foreign related literature about the lower limb lengthening by intramedullary nail was reviewed, summarized, and analyzed. Results The intramedullary nail lengthening systems can be divided into 3 types:distraction by mechanical strength, by motorized electronic power, or by motorized magnetic force. The new technology has obvious advantages in complication incidence, limb function, bone healing rate, comfortable and cosmetic degree of the patients, and hospitalization days compared with the external fixation, but it also has the disadvantages including lengthening failure of system breakdown, intramedullary infection, injuries of vessel and nerve, limited distraction length, and expensive price of the apparatus. And the method also has several contraindications:narrow medulla, multiple curves of medulla, osteomyelitis, skin infection, and unclosed epiphyseal plate. Conclusion The lower limb lengthening by intramedullary nail is a major improvement of Ilizarov technology. Although the method has been used in limited cases, the preliminary clinical results are excellent, and it can be regarded as a new trend of the limb lengthening, bone reconstruction, and deformity correction.

Citation： LIMeng, ZENGPing, QINGSihe. RESEARCH PROGRESS IN LOWER LIMB LENGTHENING BY INTRAMEDULLARY NAIL. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(5): 647-650. doi: 10.7507/1002-1892.20160129 Copy

1.	Paley D, Herzenberg JE, Tetsworth K, et al. Deformity planning for frontal and sagittal plane corrective osteotomies. Orthop Clin North Am, 1994, 25(3):425-465.
2.	Paley D, Herzenberg JE, Paremain G, et al. Femoral lengthening over an intramedullary nail. A matched-case comparison with Ilizarov femoral lengthening. J Bone Joint Surg (Am), 1997, 79(10):1464-1480.
3.	Blondel B, Launay F, Glard Y, et al. Limb lengthening and deformity correction in children using hexapodal external fixation:preliminary results for 36 cases. Orthop Traumatol Surg Res, 2009, 95(6):425-430.
4.	Mahboubian S, Seah M, Fragomen AT, et al. Femoral lengthening with lengthening over a nail has fewer complications than intramedullary skeletal kinetic distraction. Clin Orthop Relat Res, 2012, 470(4):1221-1231.
5.	Rozbruch SR, Kleinman D, Fragomen AT, et al. Limb lengthening and then insertion of an intramedullary nail:a case-matched comparison. Clin Orthop Relat Res, 2008, 466(12):2923-2932.
6.	Guichet JM, Deromedis B, Donnan LT, et al. Gradual femoral lengthening with the Albizzia intramedullary nail. J Bone Joint Surg (Am), 2003, 85-A(5):838-848.
7.	Cole JD, Justin D, Kasparis T, et al. The intramedullary skeletal kinetic distractor (ISKD):first clinical results of a new intramedullary nail for lengthening of the femur and tibia. Injury, 2001, 32Suppl 4:SD129-139.
8.	García-Cimbrelo E, Curto de la Mano A, García-Rey E, et al. The intramedullary elongation nail for femoral lengthening. J Bone Joint Surg (Br), 2002, 84(7):971-977.
9.	Wang K, Edwards E. Intramedullary skeletal kinetic distractor in the treatment of leg length discrepancy-a review of 16 cases and analysis of complications. J Orthop Trauma, 2012, 26(9):e138-144.
10.	Burghardt RD, Herzenberg JE, Specht SC, et al. Mechanical failure of the Intramedullary Skeletal Kinetic Distractor in limb lengthening. J Bone Joint Surg (Br), 2011, 93(5):639-643.
11.	Baumgart R, Betz A, Schweiberer L. A fully implantable motorized intramedullary nail for limb lengthening and bone transport. Clin Orthop Relat Res, 1997, (343):135-143.
12.	Krieg AH, Lenze U, Speth BM, et al. Intramedullary leg lengthening with a motorized nail. Acta Orthop, 2011, 82(3):344-350.
13.	Dinçyürek H, Kocaoğlu M, Eralp IL, et al. Functional results of lower extremity lengthening by motorized intramedullary nails. Acta Orthop Traumatol Turc, 2012, 46(1):42-49.
14.	Thaller PH, Fürmetz J, Wolf F, et al. Limb lengthening with fully implantable magnetically actuated mechanical nails (PHENIX(^®))-preliminary results. Injury, 2014, 45Suppl 1:S60-65.
15.	Kirane YM, Fragomen AT, Rozbruch SR. Precision of the PRECICE internal bone lengthening nail. Clin Orthop Relat Res, 2014, 472(12):3869-3878.
16.	Schiedel FM, Vogt B, Tretow HL, et al. How precise is the PRECICE compared to the ISKD in intramedullary limb lengthening? Reliability and safety in 26 procedures. Acta Orthop, 2014, 85(3):293-298.
17.	Rozbruch SR, Birch JG, Dahl MT, et al. Motorized intramedullary nail for management of limb-length discrepancy and deformity. J Am Acad Orthop Surg, 2014, 22(7):403-409.
18.	Dahl MT. Motorized, Telescopic, Intramedullary Lengthening Nails for Limb Length and Deformity Correction. Tech Orthop, 2015, 30(3):189-206.
19.	Konofaos P, Kashyap A, Neel MD, et al. A novel device for long bone osteodistraction:description of device and case series. Plast Reconstr Surg, 2012, 130(3):418e-422e.
20.	Kold S, Christensen KS. Bone transport of the tibia with a motorized intramedullary lengthening nail-a case report. Acta Orthop, 2014, 85(2):211-213.
21.	Burghardt RD, Paley D, Specht SC, et al. The effect on mechanical axis deviation of femoral lengthening with an intramedullary telescopic nail. J Bone Joint Surg (Br), 2012, 94(9):1241-1245.
22.	Paley D, Herzenberg J, Bor N. Fixator-assisted nailing of femoral and tibial deformities. Tech Orthop, 1997, 12(4):260-275.
23.	Baumgart R. The reverse planning method for lengthening of the lower limb using a straight intramedullary nail with or without deformity correction. A new method. Oper Orthop Traumatol, 2009, 21(2):221-233.
24.	Horn J, Grimsrud Ø, Dagsgard AH, et al. Femoral lengthening with a motorized intramedullary nail. Acta Orthop, 2015, 86(2):248-256.
25.	Lee DH, Ryu KJ, Song HR, et al. Complications of the Intramedullary Skeletal Kinetic Distractor (ISKD) in distraction osteogenesis. Clin Orthop Relat Res, 2014, 472(12):3852-3859.
26.	Karakoyun O, Küçükkaya M, Sökücü S. Intramedullary skeletal kinetic distractor in lower extremity lengthening. Acta Orthop Traumatol Turc, 2014, 48(3):307-312.

1. Paley D, Herzenberg JE, Tetsworth K, et al. Deformity planning for frontal and sagittal plane corrective osteotomies. Orthop Clin North Am, 1994, 25(3):425-465.
2. Paley D, Herzenberg JE, Paremain G, et al. Femoral lengthening over an intramedullary nail. A matched-case comparison with Ilizarov femoral lengthening. J Bone Joint Surg (Am), 1997, 79(10):1464-1480.
3. Blondel B, Launay F, Glard Y, et al. Limb lengthening and deformity correction in children using hexapodal external fixation:preliminary results for 36 cases. Orthop Traumatol Surg Res, 2009, 95(6):425-430.
4. Mahboubian S, Seah M, Fragomen AT, et al. Femoral lengthening with lengthening over a nail has fewer complications than intramedullary skeletal kinetic distraction. Clin Orthop Relat Res, 2012, 470(4):1221-1231.
5. Rozbruch SR, Kleinman D, Fragomen AT, et al. Limb lengthening and then insertion of an intramedullary nail:a case-matched comparison. Clin Orthop Relat Res, 2008, 466(12):2923-2932.
6. Guichet JM, Deromedis B, Donnan LT, et al. Gradual femoral lengthening with the Albizzia intramedullary nail. J Bone Joint Surg (Am), 2003, 85-A(5):838-848.
7. Cole JD, Justin D, Kasparis T, et al. The intramedullary skeletal kinetic distractor (ISKD):first clinical results of a new intramedullary nail for lengthening of the femur and tibia. Injury, 2001, 32Suppl 4:SD129-139.
8. García-Cimbrelo E, Curto de la Mano A, García-Rey E, et al. The intramedullary elongation nail for femoral lengthening. J Bone Joint Surg (Br), 2002, 84(7):971-977.
9. Wang K, Edwards E. Intramedullary skeletal kinetic distractor in the treatment of leg length discrepancy-a review of 16 cases and analysis of complications. J Orthop Trauma, 2012, 26(9):e138-144.
10. Burghardt RD, Herzenberg JE, Specht SC, et al. Mechanical failure of the Intramedullary Skeletal Kinetic Distractor in limb lengthening. J Bone Joint Surg (Br), 2011, 93(5):639-643.
11. Baumgart R, Betz A, Schweiberer L. A fully implantable motorized intramedullary nail for limb lengthening and bone transport. Clin Orthop Relat Res, 1997, (343):135-143.
12. Krieg AH, Lenze U, Speth BM, et al. Intramedullary leg lengthening with a motorized nail. Acta Orthop, 2011, 82(3):344-350.
13. Dinçyürek H, Kocaoğlu M, Eralp IL, et al. Functional results of lower extremity lengthening by motorized intramedullary nails. Acta Orthop Traumatol Turc, 2012, 46(1):42-49.
14. Thaller PH, Fürmetz J, Wolf F, et al. Limb lengthening with fully implantable magnetically actuated mechanical nails (PHENIX(^®))-preliminary results. Injury, 2014, 45Suppl 1:S60-65.
15. Kirane YM, Fragomen AT, Rozbruch SR. Precision of the PRECICE internal bone lengthening nail. Clin Orthop Relat Res, 2014, 472(12):3869-3878.
16. Schiedel FM, Vogt B, Tretow HL, et al. How precise is the PRECICE compared to the ISKD in intramedullary limb lengthening? Reliability and safety in 26 procedures. Acta Orthop, 2014, 85(3):293-298.
17. Rozbruch SR, Birch JG, Dahl MT, et al. Motorized intramedullary nail for management of limb-length discrepancy and deformity. J Am Acad Orthop Surg, 2014, 22(7):403-409.
18. Dahl MT. Motorized, Telescopic, Intramedullary Lengthening Nails for Limb Length and Deformity Correction. Tech Orthop, 2015, 30(3):189-206.
19. Konofaos P, Kashyap A, Neel MD, et al. A novel device for long bone osteodistraction:description of device and case series. Plast Reconstr Surg, 2012, 130(3):418e-422e.
20. Kold S, Christensen KS. Bone transport of the tibia with a motorized intramedullary lengthening nail-a case report. Acta Orthop, 2014, 85(2):211-213.
21. Burghardt RD, Paley D, Specht SC, et al. The effect on mechanical axis deviation of femoral lengthening with an intramedullary telescopic nail. J Bone Joint Surg (Br), 2012, 94(9):1241-1245.
22. Paley D, Herzenberg J, Bor N. Fixator-assisted nailing of femoral and tibial deformities. Tech Orthop, 1997, 12(4):260-275.
23. Baumgart R. The reverse planning method for lengthening of the lower limb using a straight intramedullary nail with or without deformity correction. A new method. Oper Orthop Traumatol, 2009, 21(2):221-233.
24. Horn J, Grimsrud Ø, Dagsgard AH, et al. Femoral lengthening with a motorized intramedullary nail. Acta Orthop, 2015, 86(2):248-256.
25. Lee DH, Ryu KJ, Song HR, et al. Complications of the Intramedullary Skeletal Kinetic Distractor (ISKD) in distraction osteogenesis. Clin Orthop Relat Res, 2014, 472(12):3852-3859.
26. Karakoyun O, Küçükkaya M, Sökücü S. Intramedullary skeletal kinetic distractor in lower extremity lengthening. Acta Orthop Traumatol Turc, 2014, 48(3):307-312.

Chinese Journal of Reparative and Reconstructive Surgery

RESEARCH PROGRESS IN LOWER LIMB LENGTHENING BY INTRAMEDULLARY NAIL

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