Limb lengthening and deformity correction in children with abnormal bone.

Area of Science:

• Orthopedic Surgery
• Pediatric Orthopedics
• Biomaterials Engineering

Background:

• Abnormal bone conditions like Ollier's disease, fibrous dysplasia, and osteogenesis imperfecta present challenges in limb lengthening and deformity correction.
• External fixation is often used but can be combined with internal fixation for enhanced stability and outcomes.

Purpose of the Study:

• To review the literature and present the authors' experience using flexible intramedullary nailing (FIN) for limb lengthening in children with abnormal bone.
• To evaluate the efficacy and long-term benefits of FIN in complex pediatric orthopedic cases.

Main Methods:

• Literature review of FIN in limb lengthening and deformity correction.
• Clinical case series involving pediatric patients with abnormal bone conditions undergoing limb lengthening with FIN and external fixation.
• Use of titanium and hydroxyapatite-coated bent elastic nails.

Main Results:

• Flexible intramedullary nailing (FIN), particularly with hydroxyapatite-coated nails, is suitable for limb lengthening in children with abnormal bone.
• FIN left in situ after external frame removal provides long-term reinforcement for lengthened bone in patients with compromised bone tissue.
• The technique respects bone biology, promoting good consolidation and stable implant positioning without migration risks.

Conclusions:

• Flexible intramedullary nailing is a valuable technique for limb lengthening and deformity correction in pediatric patients with abnormal bone.
• Hydroxyapatite-coated nails offer osteoactive properties favorable for bone formation and long-term stability.
• FIN is recommended for long-term bone reinforcement in patients with metabolic bone disorders and skeletal dysplasias.