Maximizing length with precice nail: a novel technique

Abstract

Intramedullary magnetic lengthening nails represents a marked advance in the process of limb lengthening, reducing the complications associated with other methods, and improving patient's comfort. However, one important limitation is its lengthening ability, especially when it comes to short bones. Previous reports have shown techniques that may allow further lengthening but at a cost of having to carry out repeated procedures, requiring the use of other devices, and submitting the patient to long-winded surgical procedures. This report presents a novel technique to achieve lengthening beyond the initial reach of the nail, in a simple and quick procedure, without the need of implanting any additional devices.

Breakage of a re-activated PRECICE® nail: A case report

“…Therefore, the surgeons tend to try different ways to get the maximum benefit out of these nails. For the sake of gaining farther lengths beyond nail maximum lengthening limit, some authors attempted unlocking of the distal nail end followed by nail retraction, re-locking, then further lengthening [15] , [16] . Similarly, sleeper lengthening nails represent another approach in which the patient requires additional session of lengthening after consolidation.…”

Two-stage Bone Lengthening With Reuse of a Single Intramedullary Telescopic Nail in Patients With Achondroplasia

“…Together, this body of research shows that all the lengthening procedures to date have been accomplished with EF, apart from one case report that uses a telescopic nail. 12 TIMNs have not been used alone for this purpose due to the limited elongation provided by the size of the nails that can be used in achondroplastic patients (under 5 cm), which is insufficient for them. To our knowledge, this is the first study published of limb lengthening with a single TIMN in a series of patients with achondroplasia.…”

“…Nails that are suitable for achondroplastic patients are too short, hence the distraction distance is limited up to 5 cm per nail. Therefore, there are no published studies to date concerning lengthening with a single TIMN in achondroplastic children, except for 1 case report 12. When a patient with achondroplasia requires further lengthening, the TIMN must be replaced, leading to potential complications and increased costs associated with placement of a new intramedullary device.…”

What’s New in Limb Lengthening and Deformity Correction

“…Gomez-Alessandri et al described using a single internal lengthening nail to achieve a 10-cm lengthening. Using the fast distractor intraoperatively to retract the nail fully, the authors were able to accomplish 2 separate 5-cm lengthenings in 1 treatment course without having to use additional implants 75 .…”