Motorized Intramedullary Bone Transport Nail for Reconstruction of a Large Diaphyseal Bone Defect after Tumor...

Reconstructing large bone defects in pediatric patients after tumor resection is challenging, as conventional techniques are associated with high complication rates and morbidity. The Intramedullary Bone Transport Nail (IMBTN) may reduce these complications while preserving limb alignment and skeletal growth in pediatric oncologic reconstruction.

A 15-year-old female with an osteofibrous dysplasia-like adamantinoma of the tibial diaphysis underwent complete en-bloc resection, leaving a 9 cm bone defect. An IMBTN (Precice, NuVasive) was implanted for distraction osteogenesis, with distraction starting eight days post-surgery at 0.25 mm twice daily. Follow-up visits monitored bone healing, alignment, and limb length.

The 9 cm defect was successfully reconstructed, with complete bone healing at the distraction site. Complete consolidation was confirmed at 18 months. The transport nail was removed at two years, and no further revisions were necessary. At two-year follow-up, the patient reported minimal pain on the Visual Analog Scale 1/10, and no recurrence of the tumor was noted.

The use of IMBTN for large bone defect reconstruction following tumor resection in pediatric patients is a safe and effective technique. It enables stable bone transport while preserving alignment, maintaining limb length, and is less invasive than traditional reconstructive approaches.