Bone Regeneration After Nail Distraction Osteogenesis: Review of Current Knowledge and Application Combined with a Case Report with Radiological, Histological, and Electron Microscopic Analysis.

Background: Limb-lengthening surgeries via nail distraction osteogenesis (DO) have become more popular lately. This provides an opportunity to study human bone that has grown longer. Case details: We present a case of a 22-year-old male who underwent internal upper and lower leg lengthening by 12 cm and 6 cm, respectively, under full weight bearing. He requested bilateral femoral shortening by 4 cm using a shortening nail, 24 months after the index surgery. The regenerated bones were harvested and analyzed. Results: Good bone quality and well-organized structure were observed in the regenerated bones compared with the native human adult bony architecture. Conclusions: This case demonstrates that bilateral bone regeneration during DO with a nail can result in a bone morphology that is comparable to that of native adult human bony macro- and micro-anatomy. This supports the effectiveness and potential of this surgical approach for limb lengthening and shortening procedures, although more investigations are necessary in this regard. [ABSTRACT FROM AUTHOR]