Bone lengthening using the Fitbone^® motorized intramedullary nail: The first experience in France - 18/03/16

Doi : 10.1016/j.otsr.2015.10.011

F. Accadbled ^a, R. Pailhé ^b,^⁎ , E. Cavaignac ^a, J. Sales de Gauzy ^a
^a Service de chirurgie orthopédique, hôpital des Enfants, CHU de Toulouse, 330, avenue de Grande-Bretagne, 31059 Toulouse cedex, France
^b Service de chirurgie orthopédique, hôpital Sud, CHU de Grenoble, avenue Kimberley, 38130 Échirolles, France

^⁎Corresponding author. Service de chirurgie orthopédique, hôpital Rangueil, 1, avenue du Pr-Jean-Poulhès, TSA 50032, 31059 Toulouse cedex, France. Tel.: +33 6 17 97 04 92; fax: +33 5 61 32 22 32.

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Abstract

Introduction

Intramedullary limb lengthening systems include mechanical systems (the Albizzia nail and the ISKD nail) as well as motorized systems with the Fitbone^® (Wittenstein, Igersheim, Germany) and the Precice^® (Ellipse Technologies, Irvine, CA, USA) nails. We hypothesized that limb lengthening using the Fitbone^® nail was reliable, reproducible, and comfortable for the patient.

Patients and methods

Between 2010 and 2013, a prospective single-center, single-operator (FA) study was conducted on patients who had undergone limb lengthening using the Fitbone^® nail. The inclusion criteria were length discrepancy of the limbs equal to or greater than 25 mm or a short stature. The exclusion criteria were indications for cosmetic reasons and/or growth plates that were still open. The lengthening parameters were assessed postoperatively and at the last follow-up. Lengthening was considered achieved when the lengthening objective did not differ by more than 5 mm. All complications were noted. A statistical analysis was performed.

Results

Twenty-six Fitbone^® nails were implanted in 23 patients, in the femur in 15 cases and the tibia in 11 cases. The patients’ mean age was 22.5 years (range: 15–53 years) and the mean follow-up was 3.4 years (range: 2–5.3 years). The limb lengthening targeted was obtained in 23 cases (88%) and the mean lengthening was 45.3±18 mm (range: 20–80 mm). The mean time to healing was 277±167 days (range: 86–638 days). The mean healing index was 73±57 days/cm for the femurs and 83.5±65 days/cm for the tibias. The mean complication rate was 15.4%.

Discussion

This study emphasizes the good short-term results of this motorized intramedullary lengthening system. An evaluation over the longer term and with a higher number of patients remains necessary.