External fixators are a well-established modality for treating fractures with bone defects, leg-length discrepancy, malunion, nonunion and other post-traumatic consequences. However, use of internal lengthening rods has remarkably increased recently for post-traumatic conditions. The main advantage of internal lengthening rods is eliminating pin-site complications. Internal lengthening rods are also associated with less pain. Motorised internal lengthening rods show promising performance in post-traumatic cases. Rigorous pre-operative planning is paramount to reducing lengthening-related complications. Certain types of internal lengthening rods offer bidirectional movement capability. Nail mechanism malfunction is a possibility with all kinds of nails. Direct doctor supervision is required, especially in the initial stages while the nail is lengthening. Internal lengthening nails are not as stiff as regular nails, with intricate internal mechanisms that can be broken under inattentive weightbearing activities. Preliminary positive outcomes indicate the role of internal lengthening rods in treating post-traumatic problems of leg-length discrepancy, malunion and nonunion.
Keywords: Accordion manoeuvre; Bone transport; Distraction osteogenesis; Fracture; Implantable lengthening rods; Internal lengthening nails; Limb-length discrepancy; Nonunion.