Going to Great Lengths for the Elderly: Motorized Intramedullary Nail Lengthening in the Seventh Decade and Beyond

Introduction: Motorized intramedullary (IM) limb lengthening has been reported in the general population. We wanted to determine whether lower limb lengthening using motorized IM nails is feasible in older adults.

Methods: Retrospective chart and radiographic review was conducted for 5 patients (3 men, 2 women) with a mean age of 67 years (range, 63-72 years). All underwent unilateral lengthening (1 tibia, 4 femora) using intramedullary nails. Initial etiology of shortening was trauma (4) and knee fusion (1). Mean lengthening goal was 3.1 cm (range, 2.5-4.0 cm).

Results: Mean follow-up after index surgery was 11.9 months (range, 5.7-21.7 months). Mean distraction index was 0.7 mm/day (range, 0.6-0.8 mm/day), and mean consolidation index was 32 days/cm (range, 28-50 days/cm). All healed without requiring bone grafting. Two complications occurred: 1 limb had osteomyelitis (required premature nail removal) and 1 limb was not lengthened for several days (remote controller device malfunction) and was treated by increasing the lengthening rate from 1 mm/day to 1.25 mm/day for 1 week.

Discussion and Conclusion: IM limb lengthening in older adults resulted in distraction, consolidation, and complication rates that are similar to outcomes reported in the general population. IM limb lengthening is a viable option to treat limb length discrepancy into the seventh and eighth decades of life.