• T Jager, D Popkov, P Lascombes, A Popkov, and P Journeau.
• Department of Pediatric Orthopaedics and Traumatology, Nancy Teaching Hospital Center, Brabois Hospital Group, Children hospital, 5, allée du Morvan, 54511 Vandœuvre, France.
• Orthop Traumatol Sur. 2012 Jun 1; 98 (4): 376-82.

PurposeMost of the techniques for forearm lengthening involve external fixation to achieve stability and provide progressive distraction. We introduce the use of elastic stable intramedullar nailing (ESIN) in combination with external circular assembly for the procedure. The purpose of this prospective study was to compare Ilizarov's classical technique with this combined technique.MethodsFifty-seven patients, with forearm length discrepancies or deformities either congenital or acquired, were prospectively followed-up. Patients were divided in two groups: 35 had only external fixation, and 22 had external fixation-ESIN combined techniques. Patients were assessed for clinical and radiographic outcome with a mean follow-up of 21 months after external device removal.ResultsOverall lengthening was 45.0mm. Healing index (HI) was 22.2d/cm with the combined technique, and 32.0 d/cm with external fixation. HI was 30% better when ESIN was used, for congenital and for overall cases. Combined technique has a lower complication rate.ConclusionAlthough forearm lengthening still remains a time-consuming procedure, ESIN can shorten external fixator wearing time. No additional complication occurred and bony complications seem to be limited by the nails. We recommend this technique, which we now use for most of our patients undergoing limb lengthening.Level Of EvidenceLevel IV.Copyright © 2012 Elsevier Masson SAS. All rights reserved.

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