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. 2015 Jan;20(1):149-54.
doi: 10.1007/s00776-014-0659-3. Epub 2014 Oct 19.

Femoral lengthening and deformity correction using the Fitbone motorized lengthening nail

Metin Küçükkaya  1 , Özgür Karakoyun, Sami Sökücü, Ramazan Soydan
Affiliations

Femoral lengthening and deformity correction using the Fitbone motorized lengthening nail

Metin Küçükkaya et al. J Orthop Sci. 2015 Jan.

Abstract

Background: This study reports our results with retrograde Fitbone insertion in patients with femoral shortening and deformity. We also present our experience regarding the benefits, complications, and factors associated with complications of the Fitbone technique.

Methods: Twelve males and ten females had femoral shortening and deformities treated using the retrograde Fitbone technique between 2009 and 2012. The etiologies were post-traumatic in 12 patients, poliomyelitis in four, cosmetic in two, congenital hypoplasia in two, achondroplasia in one, and Perthes sequela in one.

Results: The follow-up time was 30.8 months. The mean lengthening was 5.8 (range 2-14) cm. The degree of acute angular correction was 9° (5-22°) in nine cases. The time to full weight-bearing was 5.9 months. The consolidation index was 1.07 (0.75-1.62) months/cm. Complete consolidation was obtained in all cases except two. Running back was observed in two cases.

Conclusions: The Fitbone technique allows accurate deformity correction. The rigid reamers allow the surgeon to use the Fitbone even in patients with a narrow medullary canal. As this might result in poor bone regeneration, thinner lengthening nails should be considered.

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Figures

Fig. 1
Fig. 1
A 14-year-old male with 14 cm of femoral shortening, 6° varus, and 30° rotational deformity was treated with two consecutive retrograde Fitbone applications. a) Preoperative LSR while the leg length differences were compensated for using plates and the patellae were oriented anteriorly. b) The standard entry point of the K-wire for retrograde femoral nailing and medullary canal reaming was used with rigid reamers. The K-wire should be placed exactly as in the preoperative plan for accurate deformity correction. c) A 30° acute rotational correction was completed before reaming the proximal medullary canal. d) Position of the blocking screw and intraoperative alignment control using a grid plate (see the text). e) Distraction using activation of the transmitter head and the control electronics. f) The x-rays in the early postoperative period and 6 months after 8 cm of distraction. g) The Fitbone was replaced with a new one after the first distraction period, and the femur was distracted a further 6 cm. A temporary external fixator was used intraoperatively to protect the distraction site. h) LSR after 14 cm of lengthening and deformity correction
Fig. 2
Fig. 2
Close positioning of the proximal locking screw weakens the anterior cortical femur, which might increase the risk of fracture
See this image and copyright information in PMC

References

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