U Lenze1, C C Hasler, A H Krieg. 1. Kinderorthopädische Universitätsklinik, Universitätskinderspital beider Basel, Römergasse 8, CH-4005, Basel, Schweiz.
Abstract
BACKGROUND: Fractures in childhood may result in a significant leg length discrepancy (LLD). The common correction method of LLD and deformities is callotasis with external fixation. This is often associated with pain, pin site infection, muscle tethering and reduced range of movement (ROM). PATIENTS AND METHODS: Between 2006 and 2008 a total of 11 cases of posttraumatic LLD (range 2.4-4.3 cm) were treated with a fully implanted motorized lengthening device (Fitbone®). Hospitalization time, leg equalization, rehabilitation time and complications compared to external fixation were recorded. RESULTS: Leg lengthening was successfully performed in all cases, in five combined with angular and/or rotatory corrections. The mean distraction index was 1.03 mm/day (range 0.6-1.2 mm/day) and the mean consolidation index was 40 days/cm (range 25.2-50.9 days/cm). The average hospital stay was 9.8 days (range 8-20 days). Bone or soft tissue infections were not observed, nor were the complications commonly associated with external fixation. Functional results were excellent as the preoperative knee ROM was regained in all cases and with improved ROM in three cases. CONCLUSION: The Fitbone® nail is a valuable alternative to conventional methods which reduces complications commonly associated with external fixation.
BACKGROUND:Fractures in childhood may result in a significant leg length discrepancy (LLD). The common correction method of LLD and deformities is callotasis with external fixation. This is often associated with pain, pin site infection, muscle tethering and reduced range of movement (ROM). PATIENTS AND METHODS: Between 2006 and 2008 a total of 11 cases of posttraumatic LLD (range 2.4-4.3 cm) were treated with a fully implanted motorized lengthening device (Fitbone®). Hospitalization time, leg equalization, rehabilitation time and complications compared to external fixation were recorded. RESULTS: Leg lengthening was successfully performed in all cases, in five combined with angular and/or rotatory corrections. The mean distraction index was 1.03 mm/day (range 0.6-1.2 mm/day) and the mean consolidation index was 40 days/cm (range 25.2-50.9 days/cm). The average hospital stay was 9.8 days (range 8-20 days). Bone or soft tissue infections were not observed, nor were the complications commonly associated with external fixation. Functional results were excellent as the preoperative knee ROM was regained in all cases and with improved ROM in three cases. CONCLUSION: The Fitbone® nail is a valuable alternative to conventional methods which reduces complications commonly associated with external fixation.
Authors: Hans Michael Manner; Michael Huebl; Christof Radler; Rudolf Ganger; Gert Petje; Franz Grill Journal: J Child Orthop Date: 2006-12-30 Impact factor: 1.548