History of the FITBONE
The beginnings
The first observations that a bone can grow under traction go back to the German physician Bernhard von Langenbeck (1810-1887). He already suspected that this could one day become a significant treatment. It is thanks to the Russian doctor Gavriil Ilizarov (1921-1992) that these observations eventually became an established treatment method that has spread worldwide:
Living tissue is metabolically activated in both biosynthetic and proliferative ways when subjected to a slow, steady pull, a phenomenon that depends on vascularity and functional use.
This quotation from Ilizarov from 1990 describes the basics of callus distraction, the generation of bone tissue in the distraction gap. Ilizarov used rings that are placed around the outside of arms or legs and stabilize the bone with many wires through the soft tissues. The rings are connected to each other by joints and spindles and can thus guide the bone in all directions and also lengthen it. Ilizarov worked out the basics of the method over decades and achieved remarkable treatment successes, which also became known in the western world in the 1980s. Crooked legs become straight, short legs become long - at first, there seemed to be no limits to the method. However, the fantastic results were offset by the disadvantages of external fixation with permanent soft tissue irritation caused by the wires. Painful infections and unsightly scars are the consequences. Nevertheless, ring fixators are still used in many clinics today.
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Modern technology prevails
Since the 1970s, there have been repeated efforts to combine the advantages of callus distraction with the findings of modern western medicine. The main focus was on intramedullary nail techniques, which became increasingly popular in fracture treatment. The first intramedullary distraction nails were described by Götz and Schellmann (1975) and Baumann and Harms (1977). However, an external connection was always required for lengthening, so this technique was not pursued further. In 1978, Witt and Jäger presented for the first time a fully implantable distraction system which was attached to the side of the bone. However, the technical performance of the device were inadequate, so that safe functioning of the device was not guaranteed. A fully implantable distraction nail was used clinically successfully for the first time by Baumgart and Betz in 1988 and has been continuously improved since then.
FITBONE-System
The birth of FITBONE
The technical development of the first motorized distraction nail received a significant boost under the name FITBONE when in 1998 the German entrepreneur Dr. Manfred Wittenstein showed great personal interest in this innovative idea and founded the subsidiary Wittenstein intens. Here, in close cooperation with ZEM-Germany and under the direction of Roman Stauch, chief engineer and later managing director, the reliability of the implant was consistently improved to near-perfection and the range of indications was constantly expanded. In spring 2020, the FITBONE project was taken over by the American company Orthofix, which already has a great deal of experience in the field of limb corrections and lengthening with external fixators and has solid infrastructure to facilitate dissemination of proper use of FITBONE. At present, FITBONE is the only implant worldwide with an electromagnetic drive for distraction treatment with the widest range of applications.
The ZEM-Germany at Stiglmaierplatz in Munich
ZEM-Germany and its successes
After 20 years of working at the Ludwig-Maximilians-University in Munich, Professor Baumgart founded ZEM-Germany in 2006 to advance the development and clinical application of intramedullary distraction nails. It is the first center in Germany to specialize exclusively in limb correction and reconstruction, especially leg lengthening. On average, 100 lengthening treatments with FITBONE implants are carried out here every year, so that in the meantime, with almost 2000 implantations, it has the greatest experience in this field worldwide. In addition, many other corrective operations as well as bone defect treatments after accidents or after the removal of bone tumors are also carried out using innovative technology. New planning techniques such as the reverse planning method (RPM) and new instruments such as the patented Tube II system, which enables minimally invasive implantation of intramedullary nails, have been developed here. World-firsts, including the first "biological growing prosthesis" for children with bone tumors, and hip distalisation, which enables the implantation of a hip endoprosthesis in an anatomical position in cases of high hip dislocation, were used clinically for the first time at ZEM-Germany. These innovations open up completely new perspectives for affected patients. In addition, ZEM-Germany is also a training center for surgeons from all over the world who want to learn new surgical techniques. Since its foundation in 2006, more than 50 surgeons have visited ZEM-Germany.
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