Internal Lengthening Device for Congenital Femoral Deficiency and Fibular Hemimelia

Shabtai, Lior; Specht, Stacy C.; Standard, Shawn C.; Herzenberg, John E.

doi:10.1007/s11999-014-3572-3

Cited by 97 publications

(91 citation statements)

References 39 publications

(66 reference statements)

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“…Recently, Oostenbroek et al reported a complication rate of 69% per lengthened bone and showed that limb length discrepancy is the only predictor for complications after surgery [26]. The proportion of fractures in our study was 16.7% (five of 30) per lengthened segments compared with published rates of 8% to 50%, and the proportion of hip and knee contracture/stiffness was 30% (nine of 30) per lengthened segments compared with published rates of 10% to 85% [4,9,19,26,35,36,39]. Other postoperative obstacles and complications found in our series occurred within published ranges: modifications of the external fixator in the operating room (13.3%); Botox injections into the hamstrings and manipulations under anesthesia (10%); osteomyelitis (3%); loss of regenerate length (3%); quadricepsplasty (3%); and pin exchange in the operating room (3%).…”

Section: Discussioncontrasting

confidence: 45%

Lengthening With External Fixation Is Effective in Congenital Femoral Deficiency

Prince

Herzenberg

Standard

et al. 2015

Clin Orthop Relat Res

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Background Treatment of congenital femoral deficiency is a complex, multistage protocol and a variety of strategies have been devised to address joint instability, limb length inequality, and deformities. Despite being an important part of the algorithmic approach to the overall treatment of patients with congenital femoral deficiency, a reproducible, safe, and functional treatment for femoral length discrepancy in patients with mild and moderate congenital femoral deficiency has not been reported. Questions/purposes (1) Does femoral lengthening by means of distraction osteogenesis, using a monolateral external fixator, result in effective lengthening without loss of hip or knee range of motion? (2) Does femoral lengthening cause an inhibition of femoral growth in patients with congenital femoral deficiency? (3) Do patients/families report satisfactory functional and emotional outcomes after undergoing femoral lengthening? (4) (Schaumburg, IL, USA), Pega Medical, and Springer (New York, NY, USA) outside the submitted work. The institution of one or more of the authors (JEH, SCS, DP) has received, during the study period, funding from Smith & Nephew, DePuy Synthes, Orthofix, Biomet, and OrthoPediatrics. One or more of the authors certifies that he (SCS), or a member of his or her immediate family, has received or may receive payments or benefits, during the study period, an amount less than USD 10,000 from Smith & Nephew, an amount less than USD 10,000 from Ellipse Technologies, and an amount less than USD 10,000 from Orthofix. One or more of the authors certifies that he (DP), or a member of his or her immediate family, has received or may receive payments or benefits, during the study period, an amount of USD 100,001 to USD 1,000,000 from Orthofix, Inc during the period of this study. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Clinical Orthopaedics and Related Research 1 neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA approval status, of any drug or device before clinical use. Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained. 123Clin Orthop Relat Res (2015) 473:3261-3271 DOI 10.1007 Clinical Orthopaedics and Related Research ® A Publication of The Association of Bone and Joint Surgeons® 1a, 1b, or 2a that had not previously undergone lengthening and had stable hip and knee joints. Of the 32 patients that completed treatment, 30 (94%) were available at a minimum of 2 years (mean, 3 years; range, 2-4.5 years) and were evaluated in this retrospective study. Preoperative and postoperative radiographic analysis, physiotherapy data, patient-based outcomes s...

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Section: Discussioncontrasting

confidence: 45%

Lengthening With External Fixation Is Effective in Congenital Femoral Deficiency

Prince

Herzenberg

Standard

et al. 2015

Clin Orthop Relat Res

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“…Shabtai et al (2014) reported a prospective, nonrandomized, single-center study to evaluate the PRECICE system in terms of healing index, complications, accuracy of the device's external controller and adjacent-joint ROM [24]. Institutional Review Board approval was obtained prior to performing any studyrelated procedures.…”

Section: Internal Lengthening Device For Congenital Femoral Deficiencmentioning

confidence: 99%

PRECICE intramedullary limb lengthening system

Paley

2015

Expert Review of Medical Devices

169

140

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The PRECICE(®) Intramedullary Limb Lengthening System (Ellipse Technologies Inc., CA, USA) is a remotely controlled, magnetically driven, implantable limb lengthening intramedullary nail system. It has both CE mark and US FDA clearance for its first- (2011) and second-generation (2013) implants. It is indicated for the treatment of limb length discrepancy and short stature. It has been used worldwide in over 1000 cases. Its reported and published results in over 250 cases has been excellent with less pain and lower complication rates than with external fixation methods or previous implantable nail systems.

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“…However, with internal lengthening devices, pinsite infection and soft tissue tethering can be effectively avoided [6]. Cost is a consideration with internal lengthening rods, as they are almost twice as costly as the hexapod fixator [7,8].…”

Section: Introductionmentioning

confidence: 99%

Use of internal lengthening nails in post-traumatic sequelae

Alrabai

Gesheff

Conway

2017

International Orthopaedics (SICOT)

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External fixators are a well-established modality for treating fractures with bone defects, leg-length discrepancy, malunion, nonunion and other post-traumatic consequences. However, use of internal lengthening rods has remarkably increased recently for post-traumatic conditions. The main advantage of internal lengthening rods is eliminating pin-site complications. Internal lengthening rods are also associated with less pain. Motorised internal lengthening rods show promising performance in post-traumatic cases. Rigorous pre-operative planning is paramount to reducing lengthening-related complications. Certain types of internal lengthening rods offer bidirectional movement capability. Nail mechanism malfunction is a possibility with all kinds of nails. Direct doctor supervision is required, especially in the initial stages while the nail is lengthening. Internal lengthening nails are not as stiff as regular nails, with intricate internal mechanisms that can be broken under inattentive weightbearing activities. Preliminary positive outcomes indicate the role of internal lengthening rods in treating posttraumatic problems of leg-length discrepancy, malunion and nonunion.

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Internal Lengthening Device for Congenital Femoral Deficiency and Fibular Hemimelia

Cited by 97 publications

References 39 publications

Lengthening With External Fixation Is Effective in Congenital Femoral Deficiency

Lengthening With External Fixation Is Effective in Congenital Femoral Deficiency

PRECICE intramedullary limb lengthening system

Use of internal lengthening nails in post-traumatic sequelae

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