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Preliminary results with a fully implantable
motorized nail for limb lengthening in
adolescent patients
A. H. Krieg, B. Speth, B. C. Foster
Pediatric Orthopedic University Clinic,
University Childrens Hospital (UKBB) Basle,
Switzerland Pediatric Orthopedic Department,
Womens and Childrens Hospital (WCH) Adelaide,
Australia
INTRODUCTION
RESULTS
DISCUSSION
correction of MAD 22 mm to 5 mm
(n6) average functional score 80 points
(excellent 3, good 4, fair 1) two
patients excluded due to device failure and nail
break mean distraction distance 3.8 cm
(2.9-4.7) distraction index 1.1mm/day
(0.9-1.2) full weight bearing between 2.5 - 4
months depending of the average consolidation
index of 2.6 days/mm (1.9-4.1) ? mean
consolidation time 94 days (70-120) femur 88
days (70-96)
Leg lengthening usually performed with external
fixator ? soft tissue transfixation by pins and
wires ? high risk of complications muscle
contractures joint stiffness pain
infections secondary axial deformity
fractures through the callus formation
high operative effort high implant cost
limited distraction stroke
small risk of infection multiple correction
tool guarantee for axial alignment few pain
high comfort during treatment good cosmetic
outcome
17 year old boy with a supracondylar displaced
femur fracture (Fig. 3)
Fitbone TAA (Telescope Active Acuator) fully
implantable distraction nail system
programmable motor driven modular
stainless steel
conservative treatment in Africa
CONCLUSION
Fig. 1 Fitbone TAA
main advantages reduction of risks
associated with distraction techniques using
external fixators (infection, restricition of
mobility, discomfort, scarring) good
angular correction in cases with mechanical
axis deviation short time of hospitalisation
and rehabilitation
MATERIALS AND METHODS
preoperative characteristics 8 patients
5 male, mean age 15.1(13-18) mean
lengthening distance 3.9 cm (3-5) valgus
deformity (n6) mechanical axis deviation
(MAD) 22 mm difficulty level 6.6 points (3
to 10) congenital disease 50, trauma 25,
infection 25
Fig. 3 Leg length discrepancy of - 5 cm and
dorsal translation of one bone diameter with
slight varus deformity
good results for the anatomical and functional
correction of leg lengthening promising
procedure for limb lengthening further
investigation to show whether the
above-mentioned benefits outweigh the high
operative effort and costs of the implant
Femur (n6) Tibia (n2)
mean follow up 22.2 months (12-30) radiologica
l images Paley1 scores (modified for tibia)
Fig. 2 Fitbone TAA 12/10 Tibia 29 mm distraction
after 30 days
Fig. 4 Postoperative after implantation of
Fitbone TAA Femur 13
Fig. 5 3 months postoperative 48 mm
distraction, full ROM, full weight bearing
1Paley D et al. J Bone Joint Surg 1997, Am
791464-80