Georgiadis Andrew G, Nahm Nickolas J, Dahl Mark T
Department of Orthopaedic Surgery, Gillette Children's Specialty Healthcare, St. Paul; Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota, United States of America.
Strategies Trauma Limb Reconstr. 2023 May-Aug;18(2):106-110. doi: 10.5005/jp-journals-10080-1592.
This study reviews the re-use of implanted motorised intramedullary lengthening nails previously used for limb lengthening.
A retrospective review was performed on the re-use of motorised intramedullary lengthening nails. All patients had a magnetically controlled intramedullary lengthening nail in the femur, tibia, or humerus previously utilised for either lengthening or compression. Patients were included if the magnetically controlled intramedullary lengthening nail underwent attempted re-use either in the same lengthening episode or in a temporally separate lengthening treatment requiring another corticotomy.
Ten patients with 12 lengthening episodes were analysed including five tibial, five femoral and two humeral segments. Overall, seven of 12 nails (58%) were successfully re-deployed without the need for nail exchange. Two of three nails were successfully retracted and re-used for continued distraction in the same lengthening treatment. Five of nine nails (56%) were successfully reactivated in a subsequent, later lengthening episode.
Re-use of a magnetically controlled limb lengthening nail is an off-label technique that may be considered for patients requiring ongoing or later lengthening of the femur, tibia or humerus. Regardless of whether the nail is used in the same lengthening episode or separate lengthening episode, surgeons should be prepared for exchange to a new implant.
Re-use of a magnetically controlled intramedullary lengthening nail will reduce surgical trauma and save implant cost in limb lengthening treatment but may only be possible in half of attempted cases.
Georgiadis AG, Nahm NJ, Dahl MT. Re-use of Motorised Intramedullary Limb Lengthening Nails. Strategies Trauma Limb Reconstr 2023;18(2):106-110.
本研究回顾了先前用于肢体延长的植入式电动髓内延长钉的再利用情况。
对电动髓内延长钉的再利用进行了回顾性研究。所有患者的股骨、胫骨或肱骨中均曾植入过磁控髓内延长钉,该钉先前用于延长或加压。如果磁控髓内延长钉在同一延长疗程中或在需要再次行骨皮质切开术的时间上分开的延长治疗中尝试进行再利用,则纳入研究。
分析了10例患者的12次延长疗程,包括5例胫骨节段、5例股骨节段和2例肱骨节段。总体而言,12枚钉子中有7枚(58%)成功重新部署,无需更换钉子。3枚钉子中有2枚成功回缩,并在同一延长治疗中重新用于继续牵张。9枚钉子中有5枚(56%)在随后的延长疗程中成功重新激活。
磁控肢体延长钉的再利用是一种超说明书技术,对于需要对股骨、胫骨或肱骨进行持续或后续延长的患者可考虑采用。无论钉子是在同一延长疗程中还是在分开的延长疗程中使用,外科医生都应做好更换新植入物的准备。
磁控髓内延长钉的再利用将减少肢体延长治疗中的手术创伤并节省植入物成本,但在半数尝试的病例中才有可能实现。
Georgiadis AG, Nahm NJ, Dahl MT. 电动髓内肢体延长钉的再利用。创伤肢体重建策略2023;18(2):106 - 110。