Thaller Peter H, Frankenberg Felix, Degen Nikolaus, Soo Chris, Wolf Florian, Euler Ekkehard, Fürmetz Julian
3DSurgery, Department of General, Trauma and Reconstructive Surgery, Munich University Hospital, LMU, Germany.
Department Trauma and Reconstructive Surgery, Klinikum München Süd, Germany.
Strategies Trauma Limb Reconstr. 2020 Jan-Apr;15(1):7-12. doi: 10.5005/jp-journals-10080-1448.
Intramedullary limb lengthening has become an accepted concept in reconstructive surgery, but as yet comparative clinical studies are missing. We compared the complications and effectiveness of two types of intramedullary limb lengthening devices (ISKD®; Fitbone®).
In a retrospective series of 278 consecutive patients with internal limb lengthening, we found 17 matching pairs in terms of predefined matching parameters (group I with ISKD® and group II with Fitbone®). The surgeries were all performed with the same technique and managed with equivalent pre- and postoperative treatment protocols. The performance of the implants was evaluated using the distraction index and the weight-bearing index. Complications were rated according to Paley's classification for external lengthening.
The distraction index in group I (ISKD®) was 0.99 mm/day (range 0.55-1.67) and in the group II (Fitbone®) 0.55 mm/day (range 0.14-0.92) ( value = 0.001). The mean weight-bearing index differed between group I and group II from 32.0 day/cm (range 16.4-64.0) to 51.6 day/cm (25.8-95.0) ( value = 0.001). There were 17 recorded incidents in group I and 19 in group II during lengthening.
Specific technical handicaps of the two systems, such as the so-called runaway of the ISKD® and backtracking of the Fitbone® nails seem to result in different distraction index and weight-bearing index. Further comparative studies might induce technical progress in intramedullary limb lengthening.
Thaller PH, Frankenberg F, Degen N, Complications and Effectiveness of Intramedullary Limb Lengthening: A Matched Pair Analysis of Two Different Lengthening Nails. Strategies Trauma Limb Reconstr 2020;15(1):7-12.
髓内肢体延长术已成为重建外科中被认可的理念，但目前尚无比较性临床研究。我们比较了两种髓内肢体延长装置（ISKD®；Fitbone®）的并发症及有效性。
在一项对278例连续接受肢体延长术患者的回顾性研究中，我们根据预先设定的匹配参数找出了17对匹配病例（I组使用ISKD®，II组使用Fitbone®）。所有手术均采用相同技术，并采用等效的术前和术后治疗方案。使用牵张指数和负重指数评估植入物的性能。并发症根据Paley的外固定延长分类法进行评级。
I组（ISKD®）的牵张指数为0.99毫米/天（范围0.55 - 1.67），II组（Fitbone®）为0.55毫米/天（范围0.14 - 0.92）（P值 = 0.001）。I组和II组的平均负重指数分别为32.0天/厘米（范围16.4 - 64.0）和51.6天/厘米（25.8 - 95.0）（P值 = 0.001）。延长过程中，I组记录到17起事件，II组记录到19起。
两种系统的特定技术缺陷，如ISKD®的所谓“失控”和Fitbone®钉的“回退”，似乎导致了不同的牵张指数和负重指数。进一步的比较研究可能会推动髓内肢体延长术的技术进步。
Thaller PH, Frankenberg F, Degen N, 髓内肢体延长术的并发症及有效性：两种不同延长钉的配对分析。《创伤肢体重建策略》2020；15(1):7 - 12。
