Comparing the mechanical characteristics between leg lengthening using only an Ilizarov external fixator and leg lengthening over a nail using an external fixator manufactured in Vietnam.

PURPOSE

The mechanical characteristics of leg lengthening over a nail (LON) using an external fixator are not well known; specifically, the number of rings and K-wires required for this method has not been determined. This study aimed to compare the mechanical characteristics of leg LON using the simplest configuration for a domestic frame and those of leg lengthening using the Ilizarov frame alone.

METHODS

The mechanical characteristics of cow tibial samples for lengthening over an intramedullary nail in combination with a domestic external fixator (LON samples) and for lengthening with the Ilizarov frame (Ilizarov samples) were evaluated by assessing axial compression, bending load, and torsional load. The research indices were compression stiffness, bending stiffness, torsion stiffness, yield axial load, ultimate axial load, yield bending load, and ultimate bending load.

RESULTS

No statistically significant differences were observed in the compression stiffness, ultimate axial load, bending stiffness, and ultimate, yield bending forces between the Ilizarov samples and LON samples. The compressive stiffness, yield axial load, and ultimate axial load of the LON samples were 98 ± 1.31 N/mm, 915 ± 23.89 N, and 1032 ± 29.86 N, respectively. The anterior-posterior bending stiffness and lateral bending stiffness of the LON samples were 122.48 ± 2.92 N/mm and 116.34 ± 3.95 N/mm, respectively. The yield anterior-posterior bending and ultimate anterior-posterior bending forces of the LON samples were 616.4 ± 3.64 N and 753.2 ± 3.49 N, respectively. The yield lateral bending and ultimate lateral bending forces of the LON samples were 624.6 ± 4.04 N and 759.0 ± 3.39 N, respectively. The axial torsional stiffness of the LON samples was 1.73 ± 0.05 N m/°, which was significantly lower than that of the Ilizarov samples (2.63 ± 0.03 N m/°).

CONCLUSION

No statistically significant differences were observed in the mechanical fixation characteristics of axial compression and bending between the Ilizarov samples and LON samples. However, the axial torsional stiffness of the Ilizarov samples was statistically greater than that of the LON samples. We recommend using the simplest configuration for domestic frames in combination with LON for limb lengthening. Partial weight-bearing is permitted in the distraction stage.

LEVEL OF EVIDENCE

Case-control study.