Display options
Cite
Boutsiadis A, Iosifidou E, Nikolaos X, et al. Lengthening Over an Existing Intramedullary Nail In Cases of Post-traumatic Femoral Shortening. Technical Note. Case Series Study. Open Orthop J. 2016;10:12-8doi: 10.2174/1874325001610010012.
Boutsiadis, A., Iosifidou, E., Nikolaos, X., & Hatzokos, I. (2016). Lengthening Over an Existing Intramedullary Nail In Cases of Post-traumatic Femoral Shortening. Technical Note. Case Series Study. The open orthopaedics journal, 1012-8. https://doi.org/10.2174/1874325001610010012
Boutsiadis, Achilleas, et al. "Lengthening Over an Existing Intramedullary Nail In Cases of Post-traumatic Femoral Shortening. Technical Note. Case Series Study." The open orthopaedics journal vol. 10 (2016): 12-8. doi: https://doi.org/10.2174/1874325001610010012
Boutsiadis A, Iosifidou E, Nikolaos X, Hatzokos I. Lengthening Over an Existing Intramedullary Nail In Cases of Post-traumatic Femoral Shortening. Technical Note. Case Series Study. Open Orthop J. 2016 Mar 17;10:12-8. doi: 10.2174/1874325001610010012. eCollection 2016. PMID: 27053972; PMCID: PMC4797680.
Copy Download .nbib Format: NLM
Share it on

Open Orthop J. 2016 Mar 17;10:12-8. doi: 10.2174/1874325001610010012. eCollection 2016.

Lengthening Over an Existing Intramedullary Nail In Cases of Post-traumatic Femoral Shortening. Technical Note. Case Series Study.

The open orthopaedics journal

Achilleas Boutsiadis, Eirini Iosifidou, Xilouris Nikolaos, Ippokratis Hatzokos

Affiliations

  1. 2 Orthopaedic Department of Aristotle University of Thessaloniki, "G. Genimatas" General Hospital, 41 Ethnikis Aminis, ZIP: 54635, Thessaloniki, Greece.

PMID: 27053972 PMCID: PMC4797680 DOI: 10.2174/1874325001610010012

Abstract

BACKGROUND: Intramedullary (IM) nailing is the method of choice for the treatment of most femoral shaft fractures. However, despite successful solid union, great initial fracture comminution can lead to significant leg length discrepancy affecting normal gait mechanics. Femoral osteotomy and distraction osteogenesis over the pre-existing IM nail could restore this limb inequality.

METHODS: Five patients with an average post-traumatic femoral shortening of 3.83 cm were presented in our department with the nail in situ. Limb lengthening was achieved with the application of a distal hybrid external rail frame over the pre-existing nail. We assumed that the choice of a distal external fixator ring with wires could facilitate the procedure and minimize the possibility of friction-contact problems with the large diameter nail.

RESULTS: The amount of length discrepancy, calculated preoperatively, was restored in all patients. The mean time in frame was 57.6 days and the external fixator index 16.978 d/cm. The mean time of total healing was 152.6 days and the average bone-healing index 44.9d/cm. No deep infection or hardware loosening was observed. One superficial pin track infection was treated successfully with oral antibiotics.

CONCLUSION: This technique utilizes the principles and advantages of lengthening over an IM nail, avoids the necessity of nail removal and minimizes the complication rates and the overall time for complete recovery.

Keywords: Distraction osteogenesis; femoral shortening; hybrid external fixator; intramedullary nail; lengthening over nail; post-traumatic length discrepancy

References

  1. Am J Orthop (Belle Mead NJ). 2008 Sep;37(9):E150-4 - PubMed
  2. Clin Orthop Relat Res. 1989 Feb;(239):263-85 - PubMed
  3. J Bone Joint Surg Am. 2004 Nov;86-A(11):2406-11 - PubMed
  4. J Orthop Trauma. 2013 Jan;27(1):e13-7 - PubMed
  5. J Am Acad Orthop Surg. 2009 May;17(5):296-305 - PubMed
  6. J Bone Joint Surg Am. 2001 Dec;83-A(12):1912 - PubMed
  7. Clin Orthop Relat Res. 1996 Sep;(330):208-16 - PubMed
  8. Acta Orthop. 2005 Apr;76(2):245-52 - PubMed
  9. Am J Orthop (Belle Mead NJ). 2007 Jun;36(6):325-8 - PubMed
  10. Clin Orthop Relat Res. 2012 Apr;470(4):1221-31 - PubMed
  11. J Orthop Trauma. 2011 Nov;25(11):681-4 - PubMed
  12. J Orthop Trauma. 2001 Feb;15(2):90-5 - PubMed
  13. ANZ J Surg. 2005 May;75(5):319-21 - PubMed
  14. J Bone Joint Surg Br. 1999 Nov;81(6):1041-5 - PubMed
  15. J Bone Joint Surg Am. 1997 Oct;79(10):1464-80 - PubMed
  16. J Orthop Trauma. 2004 Aug;18(7):403-9 - PubMed

Publication Types