Bone lengthening using fitbone(r) motorized intramedullary nail: the first experience in France.

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. LEVEL OF EVIDENCE: IV: uncontrolled, prospective, continuous study.