Lengthening of the tibia over an intramedullary nail, using the Ilizarov external fixator - Major complications and slow consolidation in 9 lengthenings

We lengthened 9 tibial segments over a nail to reduce the time in the exter nal fixator in 5 patients with constitutional shortness. The median lengthe ning was 7 (5.5-7.3) cm and the external Ilizarov frame was removed after m edian 99 (63-125) days. in spite of a short time in the external fixator, c onsolidation was slow, with a median lengthening index of 4.4 (2.4-6.1) mon ths/cm. The procedure resulted in 3 fatigue fractures of the intramedullary nail or interlocking screws that needed revision and bone grafting. In 1 p atient, a deep intramedullary infection occurred. After the experience of t hese major complications we have returned to the traditonal callotasis leng thening method described by Ilizarov.