Circular frames have been the gold standard for treating bone defects, leg-length discrepancies, malunion and non-union. However, the time required to wear the circular frames can be lengthy, patient satisfaction is generally low and complications such as re-fractures, pin site infections and amputation rate not insignificant. In recent years, the use of fully implantable systems for limb lengthening have helped to overcome many problems associated with the use of circular frames. In our institution we have now successfully used lengthening nails for non-union, malunion and bone defects and have a wealth of experience.
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