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Abstract
BackgroundThis 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.MethodsTwelve 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.ResultsThe 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.ConclusionsThe 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.
Highlights
Classical limb-lengthening techniques have disadvantages such as external fixation problems, decreased patient comfort, and rehabilitation difficulties
Fully implantable lengthening nails have been used increasingly to avoid problems associated with external fixators
The main reported complications related to this nail are motor stop, cable breakage, early or delayed consolidation, subtrochanteric fractures around the proximal locking screw, and joint contractures [9]
Summary
Classical limb-lengthening techniques have disadvantages such as external fixation problems, decreased patient comfort, and rehabilitation difficulties. While lengthening over nail techniques decrease these problems, the major reported complications are related to the pin [1,2,3]. Our experience includes fully implantable motorized lengthening nails (Fitbone, Wittenstein; Ingersheim, Germany), intramedullary skeletal kinetic distractors (ISKD; Orthofix; Lewisville, TX, USA), and PRECICE (Ellipse Technologies; Irvine, CA, USA). We report our results of retrograde Fitbone applications in patients with femoral shortening and deformity. We present our experience regarding the benefits, complications, and factors associated with complications of the motorized lengthening nails technique. This study reports our results with retrograde Fitbone insertion in patients with femoral shortening and deformity. We 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.
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