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Tibial lengthening over nails in children using modified Ender nails: preliminary results of a new treatment

Saraph, Vinay; Roposch, Andreas; Zwick, Ernst-Bernhard; Linhart, Wolfgang E.

Journal of Pediatric Orthopaedics B: November 2004 - Volume 13 - Issue 6 - p 383-388

Tibial lengthening over nails, using modified Ender nails, was performed in nine children whose mean age at surgery was 12.8 years. The prerequisite for using this technique was the absence of axial malalignment and an indication for tibial lengthening only. Lengthening was not performed in one case due to the development of a compartment syndrome after the tibial osteotomy. Breakage of one interlocking screw without loss of alignment or length was observed in one case. Superficial pin tract infections were observed in two cases. An average of 4.1 cm (range 3–4.5 cm) lengthening of the tibia was achieved in eight of the nine cases. The modified Ender nails used permitted locking at both ends after achieving the desired distraction and permitted early removal of the external fixator. The advantage of this technique is that it permits early removal of the fixator and thus decreases the incidence of fixator related problems and facilitates early rehabilitation.

Department of Paediatric Orthopaedics, Karl Franzens University, Graz, Austria

Correspondence and requests for reprints to Vinay Saraph, MD, Paediatric Orthopaedic Unit, Department of Paediatric Surgery, Karl Franzens University, Auenbruggerplatz 34, A-8036 Graz, Austria

Tel: +43 316 385 4129; fax: +43 1817 4955 1693;


© 2004 Lippincott Williams & Wilkins, Inc.