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Motorised Intramedullary Bone Transport: A Scoping Review
Edward J Füzy1, Jayesh D Haribhai1, Nando Ferreira1
1Department of Orthopaedic Surgery, Tygerberg Hospital, Stellenbosch University, Stellenbosch, Western Cape, South Africa.
Strategies in Trauma and Limb Reconstruction
|August 13, 2026
Summary
Motorised intramedullary bone transport nails (BTNs) show promise for segmental bone defects, achieving high union rates but presenting device-specific complications. Further research is needed to clarify their role in limb reconstruction.
Area of Science:
- Orthopaedic Surgery
- Biomedical Engineering
- Regenerative Medicine
Background:
- Segmental bone defects pose significant reconstructive challenges in orthopaedic surgery.
- External fixation is a traditional method, but motorised intramedullary bone transport nails (BTNs) offer a potential alternative to mitigate complications.
- The clinical efficacy and complication profile of BTNs require further investigation.
Purpose of the Study:
- To evaluate the current literature on the use of motorised intramedullary bone transport nails (BTNs) in segmental bone defect reconstruction.
- To assess the clinical efficacy, complication rates, and functional outcomes associated with BTN use.
- To identify gaps in the evidence and suggest future research directions.
Main Methods:
- A scoping review was conducted following PRISMA-ScR guidelines, searching PubMed, Google Scholar, and Cochrane Library.
- Studies published between 2010 and 2024 reporting on motorised BTNs were included.
- Data extraction focused on patient demographics, defect characteristics, treatment, complications, consolidation indices, and functional outcomes, with descriptive synthesis due to heterogeneity.
Main Results:
- Fifteen studies (61 patients) were included, primarily involving femoral defects due to trauma.
- An overall union rate of 92.3% was observed, with a mean bone healing index (BHI) of 51.36 days/cm.
- A high complication incidence (106.6%) was reported, including device failures (22%), joint contractures (14%), and delayed union (9%).
Conclusions:
- Motorised intramedullary bone transport nails (BTNs) present a viable alternative to external fixation, especially for femoral defects, but introduce unique complications.
- Evidence is limited by small, heterogeneous studies, preventing definitive conclusions on superiority over external fixation.
- Future research should prioritize multi-centre comparative studies with standardized outcomes to define the optimal role of BTNs in limb reconstruction.
