Femoral lengthening or transport in combination with an intramedullary nail
- VernacularTitle:外固定架结合髓内钉延长术治疗股骨缺损和不等长
- Author:
Lei HUANG
;
Feng ZHU
;
Shen-Dong WANG
;
- Publication Type:Journal Article
- Keywords:
Femur;
External fixator;
Intramedullary nail;
Bone defect;
Length discrepancy
- From:
Chinese Journal of Orthopaedic Trauma
2004;0(07):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To review the results of limb lengthening over an intramedullary nail in management of femoral defect and length discrepancy.Methods Femoral lengthening over an antegrade intramedullary nail was applied to treat length discrepancy of 4 to 7 cm for three cases,and femoral defects of 8 and 11 cm respectively for two cases from January 2001 to December 2003.The nail and an external fixator(Ilizarov external fixator for bone defect and Orthofix limb-reconstruction system for discrepancy)were applied concomitantly at the time of femoral osteotomy.After a mean fixation time of 16.2 days(13 to 24 days),gradual distraction began at a rate of 0.25 millimeter four times a day.When the managed femur reached the expected length,the nail was locked and the fixator was removed in patients with length discrepancy.The procedure was not finished in patients with bone defects until bony consolidation was partially seen.Results All the patients were followed up for a mean time of 36.4 months(range,22 to 47 months).The mean gain in length was 7.2 cm(range,4 to 10 cm)with good consoli- dation,the mean duration of external fixation was 5 months(range,3 to 8 months),and the mean external fixation index was 0.75 month per centimeter(range,0.57 to 1.00 month per centimeter).Neither axial deviation nor re-fracture occurred.At the last follow-up,the mean range of movement of knee was 107?(80?to 135?).Con- clusions In management of defect and length discrepancy of limbs,lengthening over an intramedullary nail has the advantages of short duration of external fixation,good protection against refracture,and earlier rehabilitation of knee joint,as well as disadvantages of long operation time,massive intraoperative bleeding,high cost and much post- operative scarring.
