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Internal Extramedullary Lengthening of the Femur With an Intramedullary Lengthening Nail: Outcomes and Technical Considerations From 2 Centers.

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Retrograde Intramedullary Femoral Lengthening With Acute Deformity Correction in Children, Adolescents, and Young Adults.

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Related Experiment Video

Updated: Feb 14, 2026

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Magnetically Controlled Intramedullary Compression Nailing for Femoral Nonunion in Osteogenesis Imperfecta: A Case

Nickolas J Nahm1,2, Andrew G Georgiadis1,2, Mark T Dahl1,2

  • 1Gillette Children's Hospital and Clinics, Saint Paul, Minnesota.

JBJS Case Connector
|February 12, 2026
PubMed
Summary

This case study shows a novel use of a motorized magnetic lengthening nail to treat a painful femoral nonunion in a patient with osteogenesis imperfecta. The modified technique achieved bone healing and pain relief, enabling improved patient mobility.

Keywords:
compressionfemoral nonunionosteogenesis imperfecta

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Area of Science:

  • Orthopedic surgery
  • Biomedical engineering
  • Bone healing

Background:

  • Osteogenesis imperfecta (OI) presents challenges in fracture management.
  • Atrophic nonunion of the femur can lead to chronic pain and immobility.
  • Traditional treatments for nonunion in OI may have limited efficacy.

Purpose of the Study:

  • To describe an innovative surgical technique for managing femoral nonunion in a patient with type III osteogenesis imperfecta.
  • To evaluate the efficacy of a modified motorized magnetic lengthening nail for achieving compression and bone union.
  • To report on pain relief and functional improvement post-intervention.

Main Methods:

  • A 51-year-old female with type III osteogenesis imperfecta presented with a diaphyseal femur fracture nonunion.
  • Retrograde nailing was performed using a motorized magnetic lengthening nail with preset distraction.
  • The nail was utilized off-label to apply gradual compression across the nonunion site.

Main Results:

  • The modified lengthening nail facilitated gradual compression of the atrophic nonunion.
  • Solid bone union was achieved at the fracture site.
  • Significant pain relief and improved ability to transfer were reported by the patient.

Conclusions:

  • Off-label modification of a lengthening nail can be an effective strategy for treating complex femoral nonunions.
  • This technique offers a method for gradual compression and healing in pathologic bone, such as in osteogenesis imperfecta.
  • The described approach successfully addressed nonunion, pain, and immobility in this challenging case.