Analysis of long-bone deformity correction in adolescents using osteosynthesis by intramedullary interlocking nails: a preliminary report

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Abstract


Aims. The purpose of this study was to analyze the initial experience with adolescents treated for long-bone deformities of the lower extremities of different etiologies using osteotomies and fixation by interlocking nails.

Materials and methods. We analyzed the accuracy of long-bone deformity correction using referent lines and angles, the time of consolidation, number of complications, and functional result.

Results. We found that the accuracy of femur deformity correction (dependent on the complicity of the deformity), as estimated by different parameters, varied from 77.8% to 91.7%. Simple deformities and deformities of moderate complicity had the most accurate correction; the group of complex multiplanar deformities of the femur had the least accurate correction. This group included five cases of residual deformity, in which three of these had an angle of residual deformity <10°. The accuracy of leg deformity correction was 90%. Evaluation of the functional results using the Lower Extremity Functional Scale indicated the high functionality of the method used.

Conclusions. Correction of long-bone deformities using intramedullary osteosynthesis by interlocking nails is an effective treatment of all types of femur and lower leg deformities. When treating complex deformities of the femur, the path to operative treatment should be complex and in most cases the nailing should be accompanied by intraoperative external fixation frame assistance.


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About the authors

Viktor A Vilensky

The Turner Scientific and Research Institute for Children’s Orthopedics

Author for correspondence.
Email: vavilensky@mail.ru
MD, PhD, senior research associate of the department of bone pathology. The Turner Scientific and Research Institute for Children’s Orthopedic

Edgar V Bukharev

The Turner Scientific and Research Institute for Children’s Orthopedics

Email: vavilensky@mail.ru
MD, PhD, research associate of the department of bone pathology. The Turner Scientific and Research Institute for Children’s Orthopedics

Timur F Zubairov

The Turner Scientific and Research Institute for Children’s Orthopedics

Email: vavilensky@mail.ru
MD, PhD, research associate of the department of bone pathology. The Turner Scientific and Research Institute for Children’s Orthopedics

Andrey A Pozdeev

The Turner Scientific and Research Institute for Children’s Orthopedics

Email: aapozdeev@gmail.com
MD, PhD, orthopedic and trauma surgeon of the department of bone pathology. The Turner Scientific and Research Institute for Children’s Orthopedics.

Aleksander P Pozdeev

The Turner Scientific and Research Institute for Children’s Orthopedics

Email: professorpozdeev@mail.ru
MD, PhD, professor, chief research associate of the department of bone pathology. The Turner Scientific and Research Institute for Children’s Orthopedics

Olga N Sosnenko

The Turner Scientific and Research Institute for Children’s Orthopedics

Email: sosnenko.olga@yandex.ru
MD, PhD, chief of the department of bone pathology. The Turner Scientific and Research Institute for Children’s Orthopedics.

References

  1. Bong MR, Koval KJ, Egol KA. The History of Intramedullary Nailing. Bulletin of the NYU Hospital for Joint Diseases. 2006;64(3):94-97.
  2. Farill J. Orthopedics in Mexico. J Bone Joint Surg Am. 1952;24:506-12.
  3. Brumback RJ, Toal TR, Murphy-Zane MS. Immediate weight-bearing after treatment of a comminuted fracture of the femoral shaft with a statically locked intramedullary nail. J Bone Joint Surg Am. 1999;81:1538-44.
  4. Lin CA, Swiontkowski M, Bhandari M, et al. Reaming does not affect functional outcomes after open and closed tibial shaft fractures: The results of a randomized controlled trial. J Orthop Trauma. 2016;30(3):142-8. doi: 10.1097/BOT.0000000000000497.
  5. Соломин Л.Н. Основы чрескостного остеосинтеза. Частные вопросы - 2. Т. 2. - 2-е изд., переработ. и доп. - М.: БИНОМ, 2015. - 2015. - 560 с. [Solomin LN. Osnovy chreskostnogo osteosinteza. Chastnye voprosy - 2. Vol. 2. 2nd edition, revised and enlarged. Moscow: BINOM; 2015:560 p. (In Russ).]
  6. Kang-Il K, Thaller PH, Ramteke A, et al. Corrective tibial osteotomy in young adults using an intramedullary nailing. Knee Surg Relat Res. 2014;26(2):88-96. doi: 10.5792/ksrr.2014.26.2.88.
  7. Marti RK, Van Heerwaarden R.J. Osteotomies for Posttraumatic Deformities. 1st edition. Davos: Thieme AO Publishing; 2008: 708 p. doi: 10.1055/b-002-79369.
  8. Paley D. Principles of deformity correction. New York: Springer-Verlag; 2005: 806 p. doi: 10.1007/978-3-642-59373-4.
  9. Rocca G, Spina M, Carpeggiani G, Schirru L. Correction of multiple complex lower limb deformities by intramedullary nailing. Injury. 2015;46(7):35-9. doi: 10.1016/S0020-1383(15)30043-7.
  10. Eralp L, Kocaoğlu M, Polat G, et al. A comparison of external fixation alone or combined with intramedullary nailing in the treatment of segmental tibial defects. Acta Orthop Belg. 2012;78(5):652-9.
  11. Gaski G, Hansen D, Willis LM, et al. Intramedullary rod fixation of fibrous dysplasia without use of bisphosphonates. J Child Orthop. 2013;7:277-283. doi: 10.1007/s11832-013-0522-7.
  12. Ippolito E, Bray EW, Corsi A, et al. Natural history and treatment of fibrous dysplasia of bone: a multicenter clinicopathologic study promoted by the European Pediatric Orthopaedic Society. J Pediatr Orthop B. 2003;12:155-177. doi: doi: 10.1097/00009957-200305000-00001.
  13. Zhang X, Shang X, Wang Y, et al. Intramedullary nailing for fibrous dysplasia of lower limbs. Oncology Letters. 2012;4: 524-528. doi: 10.3892/ol.2012.752.
  14. Koczewski P, Shadi M. Lower limb inequality treatment with subtrochanteric femoral shortening osteotomy fixed with intramedullary nail. Pol Orthop Traumatol. 2012;77:65-71.
  15. Соломин Л.Н., Щепкина Е.А., Кулеш П.Н., и др. Определение референтных линий и углов длинных трубчатых костей: пособие для врачей. РНИИТО им. Р.Р. Вредена. - СПб., 2010. - 48 с. [Solomin LN, Shhepkina EA, Kulesh PN, et al. Opredelenie referentnyh linij i uglov dlinnyh trubchatyh kostej: posobie dlja vrachej. RNIITO im. R.R.Vredena. Saint Petersburg; 2010: 48 p. (In Russ).]
  16. Соломин Л.Н., Щепкина Е.А., Виленский В.А., и др. Коррекция деформаций бедренной кости по Илизарову и основанным на компьютерной навигации аппаратом «Орто-СУВ» // Травматология и ортопедия России. - 2011. - № 3. - С. 32-39. [Solomin LN, Shhepkina EA, Vilenskij VA, et al. Correction of femur deformities by Ilizarov method and by apparatus «Ortho-SUV» based on computer navigation. Travmatologija i ortopedija Rossii. 2011;3:32-39. (In Russ).]
  17. Hsu RWW, et al. Normal axial alignment of lower extremity and load-bearing distribution at the knee. Clin Orthop. 1990;255:215-227. doi: 10.1097/00003086-199006000-00029.
  18. Соломин Л.Н., Виленский В.А. Практическая классификация деформаций длинных трубчатых костей // Травматология и ортопедия России. - 2008. - № 3 (приложение). - С. 44. [Solomin LN, Vilenskij VA. Prakticheskaja klassifikacija deformacij dlinnyh trubchatyh kostej. Travmatologija i ortopedija Rossii. 2008;3S:44. (In Russ).]

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Copyright (c) 2016 Vilensky V.A., Bukharev E.V., Zubairov T.F., Pozdeev A.A., Pozdeev A.P., Sosnenko O.N.

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