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Elastic intramedullary nailing as a complement to Ilizarov's method for forearm lengthening: a comparative pediatric
T Jager1, D Popkov, P Lascombes
1Department of Pediatric Orthopaedics and Traumatology, Nancy Teaching Hospital Center, Brabois Hospital Group, Children hospital, 5, allée du Morvan, 54511 Vandœuvre, France.
Summary
The combined technique using elastic stable intramedullary nailing (ESIN) and external fixation significantly improves forearm lengthening outcomes. This method reduces external fixator time and complications compared to traditional external fixation alone.
Area of Science:
- Orthopedic surgery
- Limb reconstruction
- Biomedical engineering
Background:
- Forearm lengthening commonly utilizes external fixation for stability and distraction.
- Elastic stable intramedullary nailing (ESIN) offers an alternative fixation method.
Purpose of the Study:
- To compare the classical Ilizarov external fixation technique with a combined external fixation-ESIN technique for forearm lengthening.
- To evaluate clinical and radiographic outcomes of both methods.
Main Methods:
- Prospective study of 57 patients with forearm length discrepancies or deformities.
- Two groups: 35 patients with external fixation only, 22 with combined external fixation-ESIN.
- Mean follow-up of 21 months post-external device removal.
Main Results:
- Overall lengthening averaged 45.0mm.
- Healing index (HI) was 30% better with the combined technique (22.2 d/cm) versus external fixation alone (32.0 d/cm).
- The combined technique demonstrated a lower complication rate.
Conclusions:
- ESIN combined with external fixation can reduce external fixator wearing time for forearm lengthening.
- This combined technique showed no additional complications and potentially limited bony complications.
- The combined technique is recommended for most forearm lengthening procedures.
