Bone lengthening using the Fitbone(®) motorized intramedullary nail: The first experience in France

Orthop Traumatol Surg Res. 2016 Apr;102(2):217-22. doi: 10.1016/j.otsr.2015.10.011. Epub 2016 Feb 10.


Introduction: Intramedullary limb lengthening systems include mechanical systems (the Albizzia nail and the ISKD nail) as well as motorized systems with the Fitbone(®) (Wittenstein, Igersheim, Germany) and the Precice(®) (Ellipse Technologies, Irvine, CA, USA) nails. We hypothesized that limb lengthening using the Fitbone(®) nail was reliable, reproducible, and comfortable for the patient.

Patients and methods: Between 2010 and 2013, a prospective single-center, single-operator (FA) study was conducted on patients who had undergone limb lengthening using the Fitbone(®) nail. The inclusion criteria were length discrepancy of the limbs equal to or greater than 25 mm or a short stature. The exclusion criteria were indications for cosmetic reasons and/or growth plates that were still open. The lengthening parameters were assessed postoperatively and at the last follow-up. Lengthening was considered achieved when the lengthening objective did not differ by more than 5 mm. All complications were noted. A statistical analysis was performed.

Results: Twenty-six Fitbone(®) nails were implanted in 23 patients, in the femur in 15 cases and the tibia in 11 cases. The patients' mean age was 22.5 years (range: 15-53 years) and the mean follow-up was 3.4 years (range: 2-5.3 years). The limb lengthening targeted was obtained in 23 cases (88%) and the mean lengthening was 45.3±18 mm (range: 20-80 mm). The mean time to healing was 277±167 days (range: 86-638 days). The mean healing index was 73±57 days/cm for the femurs and 83.5±65 days/cm for the tibias. The mean complication rate was 15.4%.

Discussion: This study emphasizes the good short-term results of this motorized intramedullary lengthening system. An evaluation over the longer term and with a higher number of patients remains necessary.

Level of evidence: IV: uncontrolled, prospective, continuous study.

Keywords: Bone lengthening; Fitbone(®); Length discrepancy; Motorized nail.

MeSH terms

  • Adolescent
  • Adult
  • Bone Lengthening / instrumentation*
  • Bone Lengthening / methods
  • Bone Nails* / adverse effects
  • Dwarfism / surgery*
  • Femur / surgery
  • France
  • Humans
  • Leg Length Inequality / surgery*
  • Middle Aged
  • Prospective Studies
  • Tibia / surgery
  • Time Factors
  • Treatment Outcome
  • Young Adult