Flexible intramedullary nail use in limb lengthening

Area of Science:

• Orthopedics
• Biomedical Engineering
• Regenerative Medicine

Background:

• Limb lengthening procedures aim to correct discrepancies and deformities.
• External fixation methods, like the Ilizarov frame, are standard but can prolong treatment.
• Flexible intramedullary nailing (FIN) is explored as an adjunct to external fixation.

Purpose of the Study:

• To evaluate the impact of combining external fixation with FIN on the healing index (HI) in limb lengthening.
• To compare the HI between children treated with external fixation alone versus external fixation plus FIN.

Main Methods:

• A comparative study involving two groups of children undergoing limb lengthening.
• Group I: Ilizarov external fixator alone (194 cases).
• Group II: Ilizarov external fixator combined with flexible intramedullary nailing (92 cases) using 1.5-2.0 mm diameter nails.

Main Results:

• Group II demonstrated a significantly lower HI across various subgroups compared to Group I.
• Reductions in HI ranged from 60% to 85% for congenital and acquired pathologies.
• External fixator duration decreased by 20-33%, with maximum reductions in forearm and femur lengthening cases.

Conclusions:

• Flexible intramedullary nailing enhances external fixation methods for limb lengthening.
• FIN respects bone biology, crucial for successful lengthening.
• The combination of Ilizarov frame and FIN significantly decreases the duration of external osteosynthesis.