@article{Vogt_Roedl_Gosheger_Toporowski_Laufer_Theil_Broeking_Frommer_2020, title={Tibial lengthening using a retrograde magnetically driven intramedullary lengthening device in 10 patients with preexisting ankle and hindfoot fusion}, volume={91}, url={https://actaorthop.org/actao/article/view/819}, DOI={10.1080/17453674.2020.1807222}, abstractNote={<div class="page" title="Page 1"> <div class="section"> <div class="layoutArea"> <div class="column"> <p><strong>Background and purpose —</strong> Motorized intramedullary lengthening nails (ILNs) have been developed as an alter- native to external fixators for long bone lengthening. The antegrade approach represents the standard method for tibial ILN insertion. In patients with preexisting ankle and hind- foot fusion a retrograde approach provides an alternative technique that has not been evaluated so far. We report the outcome of this method in 10 patients.</p> <p><strong>Patients and methods —</strong> This retrospective study included 10 patients (mean age 18 years [13–25]) with pre- existing ankle and hindfoot fusion who underwent tibial lengthening with a retrograde ILN (PRECICE). The mean leg length discrepancy (LLD) was 58 mm (36–80). The underlying conditions were congenital (n = 9) and post tumor resection (n = 1). The main outcome measures were: ILN reliability, distraction achieved, distraction index (DIX), time to bone healing, consolidation index (CIX), complica- tions, and functional results.</p> <p><strong>Results —</strong> All patients achieved the goal of lengthening (mean 48 mm [26–80]). Average DIX was 0.6 mm/day (0.5– 0.7) and mean CIX was 44 days/cm (26–60). Delayed con- solidation occurred in 2 patients and healed after ILN dynam- ization or nail exchange with grafting. Toe contractures in 2 other patients were resolved with physiotherapy or tenotomy. Until last follow-up (mean 18 months [12–30]) no true com- plications were encountered, knee motion remained unaf- fected, and full osseous consolidation occurred in all patients.</p> <p><strong>Interpretation —</strong> In patients with LLD and preexisting ankle and hindfoot fusion distal tibial lengthening using a ret- rograde ILN is a reliable alternative to the standard approach with equivalent bone healing potential and low complication rates leaving the knee unaffected.</p> </div> </div> </div> </div>}, number={6}, journal={Acta Orthopaedica}, author={Vogt, Bjoern and Roedl, Robert and Gosheger, Georg and Toporowski, Gregor and Laufer, Andrea and Theil, Christoph and Broeking, Jan Niklas and Frommer, Adrien}, year={2020}, month={Aug.}, pages={761–769 } }