Distraction Osteogenesis (Callotasis) Followed by Intramedullary Locking Nails

Distraction osteogenesis (callotasis) has been widely applied for patients with limb length inequality or massive bone defect. However, problems and complications, such as callus fracture, docking site nonunion, poor or delayed callus formation, and poor tolerance by the patient may result in failure or premature termination of this procedure. Use of the intramedullary locking nail has been reported in combination with the callotasis procedure in order to shorten the period of use of the external fixator. However, usage of intramedullary locking nails after callotasis has not yet been reported. During the period from 1990 to 2000, the authors have applied intramedallary locking nails after callotasis in 31 patients. The patients were 21 men and 10 women with age between 16 and 66 (ave.-33.5). The locking nail was inserted at an average of 3.4 (0-15) weeks after removal of the external fixator. Simultaneous autogenous bone graft and soft tissue reconstruction were also conducted in 10 and 2 patients. The purpose of this study was to evaluate the results of application of intramedullary locking nails after a callotasis procedure. All patients had consolidation and union of the callus or docking site an average of 6.4 (2 to 14) months after surgery. The estimated callus shortening was 0.7 (0 to 2.5)cm. Two patients had infection at the site of the distal screw, which was controlled after removal of the implants. The nail was removed in 17 patients at an average of 26 months after insertion. Intramedullary locking nails can be applied after callotasis. However, the patients should be closely observed for infection.

並列關鍵字

distraction osteogenesis ； traumatic bone shortening ； intramedullary locking nail ； docking site non-union

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