Lengthening With Monolateral External Fixation Versus Magnetically Motorized Intramedullary Nail in Congenital Femoral Deficiency

Szymczuk, Vivian L; Hammouda, Ahmed I.; Gesheff, Martin G.; Standard, Shawn C.; Herzenberg, John E.

doi:10.1097/bpo.0000000000001047

Cited by 54 publications

(93 citation statements)

References 21 publications

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“…However, all of the papers accurately reported the indications for surgical intervention and the surgical technique (respectively 5 points each). Studies by Szymczuk et al [ 30 ] and Hammouda et al [ 32 ] compared the PRECICE intramedullary nailing with external fixation, but in our analysis, we only took into account the PRECICE nailing results. In studies by Nasto et al [ 27 ] and Iliadis et al [ 29 ], both retrograde and antegrade approaches were used, and some tibia nailing was included.…”

Section: Resultsmentioning

confidence: 99%

“…The mean follow-up was 1.7 years when reported (Table 1 ). Concerning surgical indications, one study only focused on a single pathology; in particular, Szymczuk et al [ 30 ] focused on congenital femoral deficiency treatment for a total of 30 femurs (Table 2 ). Among other papers, the principal surgical indication was congenital femoral deficiency (19 femurs), and yet post-traumatic malformations (18 femurs), achondroplasia (8 femurs), hemihypertrophy (8 femurs) and Ollier disease (6 femurs).…”

Section: Discussionmentioning

confidence: 99%

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Limb lengthening with PRECICE magnetic nail in pediatric patients: A systematic review

Masci¹,

Palmacci²,

Vitiello³

et al. 2021

WJO

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BACKGROUND Limb lengthening techniques play an increasingly important role in the pediatric orthopedic field. The principles of the osteogenesis distraction bonded traditionally with external fixators; however, the recent deployment of fully implantable systems has been able to overcome severities related to external fixators. The PRECICE ® is an implantable limb lengthening intramedullary nail system that is remotely controlled and magnetically driven. AIM To review the current literature available on this matter in order to assess the PRECICE clinical and radiological outcomes and its possible complications in a population of pediatric patients undergoing limb lengthening. METHODS Only five studies met the inclusion criteria and were consequently included in the review for a total of 131 patients and 135 femurs. The clinical and radiological outcomes of interest were: the main lengthening obtained, the distraction rate, the period of time to full weight bearing, the consolidation index, and the Association for the Study and Application of Methods of Ilizarov score. RESULTS In conclusion, data collected from the articles under investigation were comparable with the exception of the consolidation index. Unfortunately, the study population was too small and the patients’ follow-up was too short to make definitive conclusions. CONCLUSION This review shows that the PRECICE Nail System is still a therapeutic challenge in limb lengthening for pediatric orthopedic surgeons; however, careful pre-operative planning and an accurate surgical technique could allow the correction of more complex deformities with a low rate of complications.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Limb lengthening with PRECICE magnetic nail in pediatric patients: A systematic review

Masci¹,

Palmacci²,

Vitiello³

et al. 2021

WJO

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“…Patients with an unstable knee due to congenital deficiencies are exposed to a risk of knee dislocation (Shabtai et al 2014, Black et al 2015, Szymczuk et al 2019. Despite 6 of our 10 patients having a congenital deficiency, no knee dislocation was observed.…”

Section: Discussionmentioning

confidence: 75%

“…Fully implantable intramedullary lengthening nails (ILNs) with mechanical (Guichet andCasar 1997, Cole et al 2001) and motorized (Baumgart et al 1997, Schiedel et al 2014 drive systems have been developed as an alternative to external fixators for bone lengthening (Mahboubian et al 2012, Black et al 2015, Laubscher et al 2016. Recently, magnetically driven ILNs in particular have become increasingly popular (Kirane et al 2014, Wagner et al 2017 and in contrast to external fixation provide an equally safe and more comfortable option for limb lengthening and deformity correction (Szymczuk et al 2019, Horn et al 2019. Antegrade or retrograde femoral and antegrade tibial lengthening with the PRECICE limb lengthening system (NuVasive, San Diego, CA, USA) has been assessed by several studies (Kirane et al 2014, Schiedel et al 2014, Shabtai et al 2014, Tiefenboeck et al 2016, Wiebking et al 2016, Fragomen and Rozbruch 2017, Wagner et al 2017, Iobst et al 2018, Cosic and Edwards 2020, Nasto et al 2020.…”

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confidence: 99%

Tibial lengthening using a retrograde magnetically driven intramedullary lengthening device in 10 patients with preexisting ankle and hindfoot fusion

Vogt¹,

Roedl²,

Gosheger

et al. 2020

Acta Orthopaedica

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Background and purpose — Motorized intramedullary lengthening nails (ILNs) have been developed as an alternative to external fixators for long bone lengthening. The antegrade approach represents the standard method for tibial ILN insertion. In patients with preexisting ankle and hindfoot fusion a retrograde approach provides an alternative technique that has not been evaluated so far. We report the outcome of this method in 10 patients. Patients and methods — This retrospective study included 10 patients (mean age 18 years [13–25]) with preexisting ankle and hindfoot fusion who underwent tibial lengthening with a retrograde ILN (PRECICE). The mean leg length discrepancy (LLD) was 58 mm (36–80). The underlying conditions were congenital (n = 9) and post tumor resection (n = 1). The main outcome measures were: ILN reliability, distraction achieved, distraction index (DIX), time to bone healing, consolidation index (CIX), complications, and functional results. Results — All patients achieved the goal of lengthening (mean 48 mm [26–80]). Average DIX was 0.6 mm/day (0.5–0.7) and mean CIX was 44 days/cm (26–60). Delayed consolidation occurred in 2 patients and healed after ILN dynamization or nail exchange with grafting. Toe contractures in 2 other patients were resolved with physiotherapy or tenotomy. Until last follow-up (mean 18 months [12–30]) no true complications were encountered, knee motion remained unaffected, and full osseous consolidation occurred in all patients. Interpretation — In patients with LLD and preexisting ankle and hindfoot fusion distal tibial lengthening using a retrograde ILN is a reliable alternative to the standard approach with equivalent bone healing potential and low complication rates leaving the knee unaffected.

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“…Despite the complications reported in small series of patients, the new technology of motorized intramedullary nails (MIMN) has simplified upper limb lengthening surgery and made lower limb lengthening more comfortable for patients[ 53 ]. Monolateral EF lengthening was compared with MIMN lengthening in children with congenital femoral deficiency and similar lengthening parameters[ 54 ]. The MIMN group had lower complication rates and better range of motion at the end of distraction and at consolidation.…”

Section: Current Clinical Practice and Research In The Ilizarov Techniques Of Bone Reconstructionmentioning

confidence: 99%

International recognition of the Ilizarov bone reconstruction techniques: Current practice and research (dedicated to 100^thbirthday of G. A. Ilizarov)

Malkova

Borzunov

2021

WJO

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The Ilizarov method is one of the current methods used in bone reconstruction. It originated in the middle of the past century and comprises a number of bone reconstruction techniques executed with a ring external fixator developed by Ilizarov GA. Its main merits are viable new bone formation through distraction osteogenesis, high union rates and functional use of the limb throughout the course of treatment. The study of the phenomenon of distraction osteogenesis induced by tension stress with the Ilizarov apparatus was the impetus for advancement in bone reconstruction surgery. Since then, the original method has been used along with a number of its modifications developed due to emergence of new fixation devices and techniques of their application such as hexapod external fixators and motorized intramedullary lengthening nails. They gave rise to a relatively new orthopedic subspecialty termed “limb lengthening and reconstruction surgery”. Based on a comprehensive literature search, we summarized the recent clinical practice and research in bone reconstruction by the Ilizarov method with a special focus on its modification and recognition by the world orthopedic community. The international influence of the Ilizarov method was reviewed in regard to the origin country of the authors and journal’s rating. The Ilizarov method and other techniques based on distraction osteogenesis have been used in many countries and on all populated continents. It proves its international significance and confirms the greatest contribution of Ilizarov GA to bone reconstruction surgery.

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Lengthening With Monolateral External Fixation Versus Magnetically Motorized Intramedullary Nail in Congenital Femoral Deficiency

Cited by 54 publications

References 21 publications

Limb lengthening with PRECICE magnetic nail in pediatric patients: A systematic review

Limb lengthening with PRECICE magnetic nail in pediatric patients: A systematic review

Tibial lengthening using a retrograde magnetically driven intramedullary lengthening device in 10 patients with preexisting ankle and hindfoot fusion

International recognition of the Ilizarov bone reconstruction techniques: Current practice and research (dedicated to 100^thbirthday of G. A. Ilizarov)

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Lengthening With Monolateral External Fixation Versus Magnetically Motorized Intramedullary Nail in Congenital Femoral Deficiency

Cited by 54 publications

References 21 publications

Limb lengthening with PRECICE magnetic nail in pediatric patients: A systematic review

Limb lengthening with PRECICE magnetic nail in pediatric patients: A systematic review

Tibial lengthening using a retrograde magnetically driven intramedullary lengthening device in 10 patients with preexisting ankle and hindfoot fusion

International recognition of the Ilizarov bone reconstruction techniques: Current practice and research (dedicated to 100thbirthday of G. A. Ilizarov)

Contact Info

Product

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About

International recognition of the Ilizarov bone reconstruction techniques: Current practice and research (dedicated to 100^thbirthday of G. A. Ilizarov)