Albizzia is also call GEN for Gradual Elongation over intramedullary Nail and is a
variation of Internal Lengthening Over Nails. It was developed in France by Dr Jean-Marc Guichet at the University Center (CHU) of Dijon in 1986.
The device is sping loaded. The rotation of the patient's lower extremity creates the distraction with an audible "click."
It appears to be similar to, or perhaps a precursor of the ISKD. Dr Guichet is continuing his research with the development of a new 3D-Reconstruction nail (3D-Albizzia) allowing for lengthening and axial corrections at the same time.
Bliskunov's method was pioneered in the ex-USSR by Professor Alexander Bliskunov, now deceased. It is another example of an internal lengthening device and is now practiced in the Ukraine.
The Fitbone® device is being used by Prof. Augustin Betz in Germany and appears to be the only device that uses a powered system to lengthen the legs. The bones of the leg (Tibia and/or Femur) are cut and the intramedullary telescoping nail is implanted in the bone marrow of each bone. Each end of the telescope nail is attached to each end of the cut bone. The nail is connected to an induction receiver that is placed just under the skin. An external control unit powers the telescope nail though the induction plate. A similar technique has been used to power artificial hearts.
Additional information is available from the The Fitbone® site.
The ISKD was invented by Dr. J. Dean Cole, an orthopedic surgeon and President of Orthodyne Inc. Dr. Cole is Medical Director of the Florida Hospital, Orthopaedic Institute, Fracture Care Center. This is one of the few facilities in the U.S. that performs Cosmetic Leg Lengthening. Orthofix manufactures this device. Drs. Paley and Herzenberg at the LifeBridge International Center for Limb Lengthening (ICLL) also use ISKD for Cosmetic Leg Lengthening.
The Intramedullary Skeletal Kinetic Distractor (ISKD) device uses a kinetic clutch mechanism to lengthen the leg. One segment of a rod is screwed onto another and the whole rod is inserted into the patient's bone. When the patient rotates his or her leg, the lower segment rotates over the upper one, like screwing a bolt out of a nut, and the rod lengthens, expanding the leg. The clutch ensures that the rod can rotate only in one direction. A monitor is included to track how much the leg has separated at any point in time.
The use of Lengthening Over Nails was pioneered in 1990, by Drs. Paley and Herzenberg while they practiced at the Maryland Center for Limb Lengthening & Reconstruction (MCLLR). They are now at the LifeBridge International Center for Limb Lengthening (ICLL). During the initial surgery, a metal rod is inserted into the central cavity (intramedullary) of the lower legs (the tibia bone), and then the external fixator device is attached to the bone. As the limb is lengthened, one end of the bone slides over the rod and new bone is grown around it. When the bone is fully lengthened, the external device is removed and the rod is surgically attached to each bone segment. During bone strengthening, the rod provides support instead of the more uncomfortable and unwieldy External Fixator Device. At the end of the Strengthening phase, a second operation is performed to remove the metal rod. Lengthening Over Nails decreases the duration of the Strengthening phase by two to three months.
Dr. Helong Bai at the The 8th Hospital in Chongqing, China developed a micro-wound operation for leg lengthening. This procedure uses a fixative clip instead of an Ilizarov fixator. The fixator clip covers just one side of the leg and appears to be more comfortable than the Ilizarov fixator which completely surrounds the leg.
