Surgeons at Tygerberg Hospital perform groundbreaking limb reconstruction

A team of orthopaedic surgeons at Tygerberg Hospital has performed an innovative limb reconstruction procedure, which Stellenbosch University (SU) described as the first surgery of its kind in the country, and among only a few completed worldwide.

The SU stated that the team, affiliated with the university’s limb reconstruction unit, implanted a Fitbone Transport Nail (Fitbone TLN) in a 64-year-old former police officer who suffered a gunshot wound to his right femur in 2018. Despite multiple surgeries, his fracture failed to heal, leaving him in chronic pain and with a significant limb length discrepancy.

The operation was led by Professor Nando Ferreira, head of the clinical unit for tumour, sepsis and reconstruction at Tygerberg Hospital. He was joined by Dr Edward Fuzy, Dr Jayesh Haribhai and Dr Tino-Vito Orlandi.

“Fitbone TLN is a new-generation device currently available only under custom order, and globally, only a few such cases have been performed to date. Stellenbosch University and Tygerberg Hospital were selected as one of a small number of international centres to gain early access to the Fitbone TLN,” said Dr Fuzy.

He said the patient had a 50mm bone defect in the femur and a 30mm limb length discrepancy, and added that interventions, including an intramedullary nail and later a bone graft, failed to restore stability.

The Fitbone TLN allows surgeons to treat both the bone defect and the limb length discrepancy internally and simultaneously. The technology uses bone transport, the gradual movement of healthy bone into the defect site, while also lengthening the femur to correct the height difference.

The regeneration process takes about 100 days, followed by roughly 200 days for full healing.

“This transport lengthening nail is the pinnacle of orthopaedic reconstruction surgery. There are possibly only 20 to 30 people worldwide with the technical skills to perform this operation,” Dr Fuzy said.

He added that the innovation represents a breakthrough for complex limb reconstruction, which previously required lengthy and complicated external devices.

Dr Matodzi Mukosi, chief executive at Tygerberg Hospital, said: “This achievement reflects what is possible when clinical excellence, academic collaboration, and dedicated partners come together for the benefit of patients. 

“Innovations like this ensure that our communities can start well, live well, age well, and rely on a system that runs well. It is a powerful reminder of what can be accomplished when we place patients at the centre and work together across institutions.”