Two consecutive limb lengthenings with the same PRECICE nail: a technical note

Abstract

PurposeThe most significant advance in our time about limb lengthening is the magnetic lengthening nail, as the first reports appeared to show good results with accurate lengthening rates and good regenerate bone formation. The described complication rate is generally low. They avoid external fixation elements, and are activated transcutaneously, so the patient’s pain and discomfort are reduced and the rehabilitation is faster and more effective. The aim of authors is to describe a special technical issue of the PRECICE system: the nail can be extended inside the patient limb (after the osteotomy), but it also can be retracted inside the limb after achieving the bone union.MethodsThe authors present a case in which the limb lengthening has been performed in consecutive lengthening periods using the same nail. The nail was extended and retracted by altering the settings on the external remote control as well as accurately setting the rate of distraction.ResultsAfter two consecutive femoral lengthening with the same PRECICE nail, the patient no longer has a significant lower limb length discrepancy and patient satisfaction was high. During this clinical case, we were not confronted with any type of complications.ConclusionThis technique utilizes the principles and advantages of lengthening over an magnetic lengthening nail, avoids the necessity of nail removal and minimizes the complication rates and the overall time for complete recovery.Level of evidenceLevel IV.

All Internal Bone Transport: Use of a Lengthening Nail and Double Plating for Management of Femoral Bone Loss

“…Lengthening nails have been developing over recent years with progression from the initial mechanical methods of lengthening to newer motorized devices, 22 – 24 affording greater precision of correction 25 , 26 and an ability to both lengthen and shorten as required. 27 These provide an attractive option, particularly in the femur, as they have been shown to have greater patient satisfaction, with a favourable complication profile in comparison with external methods for limb lengthening. 10 , 28 …”

“… 30 Certainly, case reports for repeat lengthening of a Precice nail left in situ have been described previously in the literature. 27 As described in our technique, we have used the same nail for more than one cycle of lengthening then retrograde transport without failure. At the time of writing, seven cycles of transport have been performed in three patients.…”

Intramedullary Bone Lengthening Following Preceding Hip Surgery—A Case Series

“…Intramedullary limb lengthening is an attractive and effective treatment method with significant advantages to external fixation. Patients report better overall satisfaction, reduced discomfort, and more effective rehabilitation as fewer limitations in physiotherapy appear [ 12 , 13 , 14 , 15 ].…”

Bone reconstruction after malignant tumour resection using a motorized lengthening intramedullary nail in adolescents: Preliminary results

“…However, this can be tackled by a nail exchange or as recently reported, nail retraction followed by further lengthening. 24 An intramedullary nail can be left in place until full maturation of the bone regenerate, thus protecting the lengthened segment from a fracture after removal of the external fixator. 22…”