How precise is the PRECICE compared to the ISKD in intramedullary limb lengthening?

Abstract

Background and purposeThe PRECICE intramedullary limb lengthening system uses a new technique with a magnetic rod and a motorized external remote controller (ERC) with rotational magnetic field. We evaluated the reliability and safety of the PRECICE system.MethodsWe compared our preliminary results with PRECICE in 24 patients (26 nails) with the known difficulties in the use of mechanical lengthening devices such as the ISKD. We used the Paley classification for evaluation of problems, obstacles, and complications.Results2 nails were primarily without function, and 24/26 nails lengthened over the desired distance. Lengthening desired was 38 mm and lengthening obtained was 37 mm. There were 2 nail breakages, 1 in the welding seam and 1 because of a fall that occurred during consolidation. ERC usage was problematic mostly in patients with femoral lengthening. Adjustment of the ERC was necessary in 10 of 24 cases. 15 cases had implant-associated problems, obstacles were seen in 5 cases, and complications were seen in each of 4 cases.InterpretaionThe reliability of the PRECICE system is comparable to that of other intramedullary lengthening devices such as the ISKD. The motorized external remote controller and its application by the patients is a weak point of the system and needs strict supervision.

Use of internal lengthening nails in post-traumatic sequelae

“…Driving mechanisms are not expected to function properly in individuals with a body mass index >35. Wide soft tissue interval >5-7 cm may interfere with external remote controller function of the PRECICE magnetically motorised nail [23].…”

Evaluation of the first experience of intramedullary nail lengthening using PRECICE® in a South African limb lengthening and reconstruction unit

“…11,19 In none of the previous studies or in the current study did any of the patients experience intolerable pain during distraction, as no external or painful rotational manipulation of the limbs was required. 19 In a previous study done by Kirane et al (2014), momentary loss of limb ROM was observed in various patients after surgery, and the original ROM recovered within a few months after surgery. 11 This was not the case in the current study, as none of the patients experienced temporary loss of ROM in the limbs.…”

“…11,19 In previous cases the nail distraction failure also occurred (non-functional magnet mechanism), in which case the nail was replaced and distraction was successfully continued. 11,19 In none of the previous studies or in the current study did any of the patients experience intolerable pain during distraction, as no external or painful rotational manipulation of the limbs was required.…”

“…11,19 In previous cases the nail distraction failure also occurred (non-functional magnet mechanism), in which case the nail was replaced and distraction was successfully continued. 11,19 In none of the previous studies or in the current study did any of the patients experience intolerable pain during distraction, as no external or painful rotational manipulation of the limbs was required. 19 In a previous study done by Kirane et al (2014), momentary loss of limb ROM was observed in various patients after surgery, and the original ROM recovered within a few months after surgery.…”

“…18 The PRECICE ® System is predicted to be more accurate and reliable than previously used ILNs and to minimise the associated complications. 11,19 The PRECICE ® System was therefore evaluated in this study based on the accuracy of distraction and implant-related complications. [11][12][13][14] This small study comprised only nine patients with 11 limbs that required lengthening.…”