TY  - JOUR
AB  - Background and purpose — Motorized intramedullary lengthening nails (ILNs) have been developed as an alter- native to external fixators for long bone lengthening. The antegrade approach represents the standard method for tibial ILN insertion. In patients with preexisting ankle and hindfoot fusion a retrograde approach provides an alternative technique that has not been evaluated so far. We report the outcome of this method in 10 patients. Patients and methods — This retrospective study included 10 patients (mean age 18 years [13–25]) with preexisting ankle and hindfoot fusion who underwent tibial lengthening with a retrograde ILN (PRECICE). The mean leg length discrepancy (LLD) was 58 mm (36–80). The underlying conditions were congenital (n = 9) and post tumor resection (n = 1). The main outcome measures were: ILN reliability, distraction achieved, distraction index (DIX), time to bone healing, consolidation index (CIX), complications, and functional results. Results — All patients achieved the goal of lengthening (mean 48 mm [26–80]). Average DIX was 0.6 mm/day (0.5– 0.7) and mean CIX was 44 days/cm (26–60). Delayed consolidation occurred in 2 patients and healed after ILN dynam- ization or nail exchange with grafting. Toe contractures in 2 other patients were resolved with physiotherapy or tenotomy. Until last follow-up (mean 18 months [12–30]) no true complications were encountered, knee motion remained unaffected, and full osseous consolidation occurred in all patients. Interpretation — In patients with LLD and preexisting ankle and hindfoot fusion distal tibial lengthening using a retrograde ILN is a reliable alternative to the standard approach with equivalent bone healing potential and low complication rates leaving the knee unaffected.
AU  - Vogt, Björn
AU  - Rödl, Robert
AU  - Gosheger, Georg
AU  - Toporowski, Gregor
AU  - Laufer, Andrea Maria
AU  - Theil, Jan-Christoph
AU  - Bröking, Jan Niklas
AU  - Frommer, Adrien
AU  - Frommer, Adrien Tobias
DA  - 2020-08-24
DO  - 10.17879/63009624895
LA  - eng
N1  - Acta Orthopaedica 91 (2020) 6, 761–769
N1  - Finanziert durch den Open-Access-Publikationsfonds der Westfälischen Wilhelms-Universität Münster (WWU Münster).
PY  - 2020-08-24
TI  - Tibial lengthening using a retrograde magnetically driven intramedullary lengthening device in 10 patients with preexisting ankle and hindfoot fusion
UR  - https://nbn-resolving.org/urn:nbn:de:hbz:6-52099698099
Y2  - 2024-11-22T06:44:33
ER  -