Fully implantable distraction nail for the treatment of shortening deformity and bone defect. Spectrum of indications

Since the first clinical experiences with the fully implantable programmabl e distraction nail nearly ten years ago, the system has been improved in Mu nich and meanwhile used in 26 patients. During the first 10 cases there has been highest interest in the reliability of the system, while in the follo wing the expansion of indications was more important. At the thigh a good i ndication beside shortening is the combination of shortening and axis devia tion, even if the center of deviation is located near to the knee joint in the supracondylar area. According to preoperative planing the deformity cor rection can be done acutely while the lengthening procedure follows postope ratively automatically at night-time. If the stabilization with an intramed ullary nail is possible, large bone defects can be treated by bone transpor t using this system also. The fully implantable intramedullary nail has pro ved its variable functions in cases of large bone defects combined with sho rtening of the femur. The system is able to perform the bone transport at f irst and the lengthening procedure automatically without any further operat ion thereafter.