No osteolysis at the telescopic junction of 128 FITBONE lengthening nails

Abstract

BackgroundMotorized lengthening nails are the treatment standard for bone lengthening of the lower limbs. However, bony changes namely osteolysis and periosteal hypertrophy have been described after certain type of magnetically driven lengthening nails. The aim of this study was to estimate the proportion rate of radiological bone abnormalities of Fitbone TAA femoral or tibial lengthening nails with a minimum follow-up time of 1 year. HypothesisThe bone surrounding the telescopic junction of Fitbone lengthening nails does not exhibit osteolysis or periosteal reactions. The bone surrounding the locking screws exhibits cortical hypertrophy. Patients and methodsSingle-centre retrospective case series of patients treated with a Fitbone nails with a minimum follow-up of 1 year after implantation. Standard orthogonal radiographs were obtained postoperatively, weekly during the distraction phase, and then monthly for 6 months, and before removal of the equipment. We looked for bone abnormalities at the telescoping junction of the nail and at the locking screws before removal. ResultsIn total, 101 patients (58 males, 43 females) with a mean age of 21 years (range: 11.8–53.5) had 128 (101 femoral and 27 tibial) limb lengthening nails implanted between 2010 and 2021. The mean follow-up period was 925 days (range: 371–3587). The mean lengthening was 4.7cm (range: 1.5–8.0). No bones exhibited focal osteolysis or periosteal reactions at the telescopic junction of the lengthening nail. Cortical hypertrophy at the locking screws was observed in significantly more Fitbone nails than previously reported, i.e., 101/128 (79%). DiscussionNeither focal osteolysis, nor periosteal reactions were observed at the bone surrounding the telescopic junction of 128 Fitbone lengthening nails. Cortical hypertrophy around the single diaphyseal locking screw was observed in 101/128 (79%) of the cases. These absences of osteolytic changes after long term observation are reassuring for both surgeons and patients alike. Level of evidenceIV.