A self-driven intramedullary nail for the reconstruction of large bone defects

This project aims to evaluate a self-driven bone transport nail developed to reconstruct large bone defects caused by trauma, deformity, or cancer. Bone transport is an intervention whereby new bone is grown in a long bone where there is a missing section. It requires the division of the intact portion of the bone leaving a segment of bone that can be transported from its location in a controlled manner using either an intramedullary nail or an external ring fixation. External fixation is the preferred technique in the UK due to lower cost and lack of availability of other options that has a number of significant limitations, which are: prolonged treatment time, diligent care, as well as psychological, hygiene, and daily activity burden for patients and caregivers. Intramedullary bone transport methods also have a number of limitations that include: the daily involvement of patients during the distraction process; regular interventions by surgeons; and the significant cost of the procedure. These limitations have led to limited use of this method regardless of its superior outcomes compared to the external fixator method.

Addressing these limitations is the subject of this project: automating the process and significantly reducing its cost can considerably promote the use of nails in the UK as the primary technique for bone transport. In this project, we will experimentally demonstrate the feasibility and accuracy of the nail using an in vivo study on sheep. We will also engage with patient groups at the Royal National Orthopaedic Hospital during the study. This is to ensure it is well accepted and can be rapidly included in the current treatment pathway within the NHS once the clinical trials have been completed.