gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2019)

22. - 25.10.2019, Berlin

Treatment of skelettaly immature patients with motorized intramedullary lengthening nails

Meeting Abstract

  • presenting/speaker Adrien Frommer - Abteilung für Kinderorthopädie, Deformitätenrekonstruktion und Fußchirurgie, Uniklinik Münster, Münster, Germany
  • Gregor Toporowski - Abteilung für Kinderorthopädie, Deformitätenrekonstruktion und Fußchirurgie, Uniklinik Münster, Münster, Germany
  • Georg Gosheger - Klinik für Allgemeine Orthopädie und Tumororthopädie, Münster, Germany
  • Niklas Bröking - Abteilung für Kinderorthopädie, Deformitätenrekonstruktion und Fußchirurgie, Uniklinik Münster, Münster, Germany
  • Andrea Laufer - Abteilung für Kinderorthopädie, Deformitätenrekonstruktion und Fußchirurgie, Uniklinik Münster, Münster, Germany
  • Anna Rachbauer - Abteilung für Kinderorthopädie, Deformitätenrekonstruktion und Fußchirurgie, Uniklinik Münster, Münster, Germany
  • Robert Rödl - Abteilung für Kinderorthopädie, Deformitätenrekonstruktion und Fußchirurgie, Uniklinik Münster, Münster, Germany
  • Björn Vogt - Abteilung für Kinderorthopädie, Deformitätenrekonstruktion und Fußchirurgie, Uniklinik Münster, Münster, Germany

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2019). Berlin, 22.-25.10.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocIN18-549

doi: 10.3205/19dkou711, urn:nbn:de:0183-19dkou7118

Veröffentlicht: 22. Oktober 2019

© 2019 Frommer et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objectives: Limb lengthening with motorized intramedullary lengthening nails is a well-established method in the treatment of adults. In contrast to external fixators, intramedullary lengthening nails provide a more comfortable and equally safe treatment. The applications of intramedullary lengthening nails for skeletally immature patients remains a challenge due to the patient's anatomy and growth considerations. Our goal is to further elucidate the indications and limitations when performing femoral and tibial lengthening procedures in children and adolescent patients.

Methods: A retrospective review (2016-2018) was performed to identify skeletally immature patients who underwent limb lengthening with motorized intramedullary nails in either an antegrad/retrograde femoral or antegrade tibial approach (Figure 1 [Fig. 1]).

Results and conclusion: On a total of 54 patients 60 procedures were performed. Three different types of nailing approaches where used: antegrade femoral (n=42), retrograde femoral (n=10), and antegrade tibial (n=8). Mean age at the time of surgery was 13.8 years. The average length of callus distraction was 45mm. In 58/60 cases (96.7%) the desired amount of lengthening was achieved, while two patients experienced complications that required interruption of the treatment. None of the patients developed complications associated to the nailing approach. Different approaches for intramedullary lengthening nails can be used in children and adolescents to correct leg length discrepancy with or without concomitant deformities. The treatment is limited by the size of the available nails, the residual growth and characteristics of the deformity. Larger trials will be needed to further validate the application of lengthening nails in skeletally immature patients.