Research progress of fully implantable intramedullary lengthening nail / 中华骨科杂志

ABSTRACT

Limb length discrepancy is caused by either congenital or acquired conditions,such as growth arrest,osteomyelitis,trauma or tumor.Conventional Limb lengthening utilizes external fixators which lead to great inconvenience to patient's daily life.Complications are however common including pin-site infection,soft tissue tethering from the pins and wires resulting in pain,regenerate deformity or fracture after frame removal and intolerance of the frames.In order to reduce the time of external fixator treatment,various combinations techniques of both external and internal fixation have been developed.However,there is still a risk of deep infection of the implant due to contamination of the previous pin tracts of the external fixation.Fullly implantable intramedullary lengthening nail can avoid the problems of external fixator,including discomfort,pin sites infection,muscular transfixation and soft tissue tethering.There are still some problems including serious pain,too quick lengthening and authorization,so the earlier generations of products could not be safely and widely used.The newest generation of magnetic intramedullary lengthening nail represented by PRECICE (NuVasive,Inc.,Irvine,CA,USA) has obtained good early clinical results with its stability,precision and controllability.PRECICE is broadly used in the world,which may become the new direction of treatment for limb lengthening and deformity correction.This article aims to review the recent development of fully implantable intramedullary lengthening nail,including clinical application,preoperative planning,key points of surgery,postoperative rehabilitation,and complications.