Current approaches to flexible intramedullary nailing for bone lengthening in children.

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Abstract

10. Clin Plast Surg. 1991 Jul;18(3):497-504. Bridging bone gaps with the Ilizarov technique. Biologic principles. Alonso JE(1), Regazzoni P. Author information: (1)Department of Surgery, University of Alabama, Birmingham. For the treatment of bone gaps of less than 4 cm, cancellous autografting remains the treatment of choice. But for gaps exceeding 4 cm, the distraction osteogenesis is a viable option. The following conditions should be satisfied: (1) patient selection; (2) stable fixation; (3) osteotomy by corticotomy; (4) 7- to 14-day latency period before initiating distraction; and (5) a controlled rate and rhythm of distraction of 1 mm per day (0.25 mm, four times a day). This type of treatment leaves the pathologic focus alone, and bone healing occurs on the healthy bone. The quality of bone regenerate may be improved by a motorized unit and by better soft-tissue coverage using early grafts and flaps. Interface healing is probably improved by cancellous grafting and internal fixation after the transport period, thus decreasing the fixator time.