Intramedullary skeletal kinetic distractor in lower extremity lengthening

Objective: The aim of this study was to report the clinical and radiological results of patients withIntramedullary Skeletal Kinetic Distractor (ISKD) lengthening. Methods: Ten femoral and 2 tibial lengthening were performed in 12 patients (7 male, 5 female; mean age: 27 years (13-40)) by using ISKD nail. The mean limb length discrepancy of the patients was 4.41 cm (2-7). On the postoperative 7th day the patients were trained about lengthening and the lengthening started. Follow-up X rays were taken weekly during the distraction period and every second weeks during the consolidation period. One patient with tibia lengthening was lost to follow-up after completing the distraction period. Results: The planned lengthening amounts were achieved in all of the cases. The mean lengthening was 4.41 cm (2-7). The mean bone healing index was 37.8 day/cm (28.5-78.0). There were uncontrolled distractions in 4 cases. Autogenous bone grafting was necessary in a case with incompetent bone formation. The kinetic nail was locked and failed to distract in a patient, in which the problem was solved with closed manipulation under anesthesia. No patient had a joint stiffness. Conclusion: Intramedullary extensible nails decrease the risk of joint contractures and infection. This procedure can be well tolerated by the patients and they can return to their daily activities earlier.