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Master Thesis

Évaluation à moyen terme des clous d’allongement mécaniques ISKD® : étude rétrospective sur 28 cas

Abstract : Introduction: bone lengthening of lower limbs is a real surgical challenge with many complications. Currently, it’s preferably performed by intramedullary nails. There are motorized and mechanical systems, such as the ISKD®(Orthofix Inc.,Texas,USA), each responsible for specific complications. Our study’s objective is to evaluate the efficacity of ISKD® using EOS® imaging, identify complications and assess functional impact. Material and methods: we performed a single-center restrospective study on 28 patients using the ISKD® between 2005 and 2018. Mean age was 29 years, with 24 femur and 4 tibia lengthenings. Main etiologies were post-traumatic or congenital. Distraction and consolidation parameters were measured using EOS®3D imaging, as well as residual leg length discrepancy at last follow-up. Complications and functional scores were identified. Results: 28 ISKD® were implanted in 14 women and 14 men. Average follow-up was 75 months. Planned elongation was obtained in 78.5% of cases (mean elongation of 34.5 mm). Mean distraction and consolidation indexes were 0.94 mm/day and 105 days/cm, respectively. Leg Length Discrepancy (LLD) were significantly corrected and functional scores improved after surgery (p <0.01). Overall complication rate was 67.9%, of which 76% were specific for the ISKD® (i.e. device-related). Discussion: this study confirms that lengthening by nail is an indication of choice for treatment of LLD but should no longer be performed by ISKD® system, because of a device-related complications rate too high. These complications are mostly distraction-control related, which is not found with new generation motorized nails.
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Submitted on : Thursday, February 27, 2020 - 6:07:40 PM
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Paul Lecoanet. Évaluation à moyen terme des clous d’allongement mécaniques ISKD® : étude rétrospective sur 28 cas. Sciences du Vivant [q-bio]. 2019. ⟨dumas-02493469⟩

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