Abstract
The treatment of complex injuries of the extremities after comminuted
fractures or non-unions is a challenging area in the field of trauma
surgery. Internal, motorized implants nowadays enable a patient-oriented and
progressive treatment of these cases. The present article aims to present
modern treatment strategies of complex injuries of the extremities, support
the use of novel, motorized intramedullary nails and provide experiences for
the handling with lengthening nails or transport nails. For this purpose,
the preoperative planning including selection of patients, presentation of
internal lengthening and transport systems and the most important factors
during preparation of the surgery are described. Moreover, critical steps
during the implantation of motorized nails and also during potential
follow-up interventions are highlighted and the postoperative protocol
including precise recommendations for the transport und consolidation phase
are provided. Finally, the experiences are illustrated by presentation of
the four different cases. The use of internal, motorized implants represents
the latest step in the treatment of complex injuries of the extremities.
These implants improve the quality of life and the authors recommend its
use. However, these implants require a high expertise and adaption of
established treatment protocols in these challenging trauma cases. Follow-up
analyses with a considerably large number of cases are necessary and the
research on implants to solve persisting problems in the area of complex
injuries of the extremities has to be pursued intensively.
Keywords
complex trauma of the extremities - non-unions - motorized intramedullary nails -
bone defect - segmental bone transport
