Motorized internal lengthening of long bones: residual limb lengthening

Jason S. Hoellwarth*, Kevin Tetsworth, Shakib S. Al-Jawazneh, Munjed Al Muderis

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)
95 Downloads (Pure)


Distraction osteogenesis can be performed for transfemoral amputees using a motorized intramedullary limb lengthening nail (LLN) such as the 14×130 mm NuVasive Freedom nail. Despite being the shortest commercially available LLN, some patients have even shorter residual femurs, making it impossible to link the bone to the nail by the standard technique of inserting a cross-locking bolt through the proximal and distal nail holes. Two modified techniques of linking a very short femur to a LLN are introduced in this manuscript. The triple cable lasso technique passes 2 cerclage cables transversely through the cortex and then the nail hole, with a third cable clamping the first 2 to the outer cortex. The contoured locking plate technique bends a locking plate to fit over the protruding distal tip of the nail, locks a screw in the plate which threads the distal nail hole, and then locks the plate to the bone with unicortical screws.

Original languageEnglish
Pages (from-to)209-213
Number of pages5
JournalTechniques in Orthopaedics
Issue number3
Publication statusPublished - Sept 2020

Bibliographical note

Copyright the Author(s) 2020. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


  • above knee amputation
  • amputation
  • Freedom nail
  • limb lengthening
  • motorized nail
  • osseointegration
  • transfemoral


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