• D Popkov, P Journeau, A Popkov, T Haumont, and P Lascombes.
• Brabois University Hospital Center, Children Hospital, Children's Orthopaedic Surgery, Vandoeuvre-Lès-Nancy, France.
• Orthop Traumatol Sur. 2010 Jun 1; 96 (4): 348-53.

IntroductionDuring progressive lower limb lengthening in the management of Ollier's disease, the mean bone-healing index usually reported in the literature stands around 35 days/cm. One of the therapeutic objectives is to reduce the duration of the external fixation.HypothesisThe use of an elastic stable intramedullary nailing system (ESIN) combined with a circular external fixator significantly reduces the healing index.Material And MethodsTwo groups of patients were compared. In group I, seven patients were operated on for progressive limb lengthening using a circular external fixator associated with an ESIN system: four monosegmental femoral lengthenings, one monosegmental tibial lengthening and two polysegmental femorotibial lengthenings. Nailing was performed via two intramedullary nails already used in traumatology. The date of external fixator removal coincided with that of radiographic healing. The nails were left in place. Group II included 37 patients who underwent limb lengthening by means of an external fixator only. The healing index was calculated and complications were analysed in both groups.ResultsThe mean healing index (HI) values were: in group I: 23.3 days/cm for the femur, 22.4 days/cm for the tibia and 11.6 days/cm for polysegmental lengthenings ; in group II: 31.6 days/cm for the femur, 35.7 days/cm for the tibia and 19.9 days/cm for polysegmental lengthenings. Group I demonstrated a statistically significant decrease in the HI for monosegmental femoral lengthenings.ConclusionA substantially reduced duration of external fixation, limited postoperative complications and prevention of later pathologic fractures are the reported advantages of the associated use of a circular external fixator with an ESIN system in the management of Ollier's disease.Level Of EvidenceLevel III, comparative retrospective study.Copyright 2010 Elsevier Masson SAS. All rights reserved.

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