Current approaches to flexible intramedullary nailing for bone lengthening in children

Abstract

Limb-length discrepancies and extremity deformities are among the most common non-traumatic orthopaedic conditions for which children are hospitalised. There is a need to develop new treatment options for lower-limb length discrepancy in order to ameliorate treatment outcomes, avoid or reduce rates of complication and provide early rehabilitation. The authors report on the basic principles, experimental and clinical data, advantages, problems and complications of a combined technique associating the Ilizarov method and flexible intramedullary nailing (FIN) in limb lengthening and deformity correction in children. They describe features of the use of hydroxyapatite-coated intramedullary nails in patients with certain metabolic bone disorders and in cases where bone consolidation has been compromised. The advantages of bone lengthening using a combined technique (circular fixator plus FIN) are a lower healing index, quicker distraction-consolidation, a reduced rate of septic and bone complications, the ability to correct deformities gradually and the increased stability of bone fragments during the external fixation period and after frame removal.

Posteromedial bowing of the tibia: A benign condition or a case for limb reconstruction?

“…The previously published use of limb-lengthening techniques in posteromedial bowing of the tibia is limited, with Shah 9 reporting two patients, Johari 7 six patients and Kaufmann et al 10 describing a series of 11 patients undergoing limb lengthening with the Ilizarov method. Newer techniques may prove to further shorten the time in frame such as lengthening over flexible nails 20 , 21 or lengthening and then plating, 22 , 23 although these techniques have not been reported in this cohort of patients.…”

Evaluation of clinical efficacy and safety of the Ilizarov apparatus for external fixation (literature review)

“…Ilizarov has been used in contemporary surgical practice and provides significant rates of positive results in the treatment of a wide range of pathology of the musculoskeletal system [1][2][3]. Technologies combining the Ilizarov apparatus with other methods have been also developed and are aimed at treating patients with orthopedic and traumatic pathologies [4][5][6][7][8][9][10].…”

Adjustable bone plate: state of art

“…ABP is a user-friendly device that protects the axial alignment of the bone during distraction. We believe that there is a gap in the literature in the optimal implant for the upper extremity distraction osteogenesis and paediatric bone lengthening [18][19][20]. ABP can fill this gap in upper extremity with its extramedullary design and eliminating the neurovascular complications of external fixators.…”