Limb Lengthening by Implantable Limb Lengthening Devices

Abstract

Implantable limb lengthening using noninvasively adjusted telescopic nails dates back to 1983. The newest technology is the Precice (Ellipse Technologies). A retrospective study of the first 65 Precice nails was carried out for the treatment of limb length discrepancy (unilateral) and short stature (bilateral). Successful lengthening was achieved in all patients. There were numerous distraction and hardware complications. Despite these, implantable limb lengthening appears to be the direction for the future of limb lengthening.

Use of internal lengthening nails in post-traumatic sequelae

“…Currently, PRECICE is the only available rod in the USA with bidirectional mechanical function [26]. Satisfactory preliminary outcomes were reported in Europe with Phenix M2 nail system, which has both lengthening and shortening modes.…”

“…IM canal overreaming by 2-mm larger than the planned nail size is required to facilitate PRECICE nail insertion. Fixator-assisted nailing is recommended during insertion to maintain the proper alignment for bone healing [26]. Blocking screws should be considered selectively wherever deformity potential is a concern [39].…”

“…Residual limbs with remarkably limited IM space do not accommodate standard internal lengthening rods. However, rod miniaturisation may have a role in stump elongation surgery [26].…”

“…External fixator should be applied to maintain the corrected position until the nail is fully seated [26]. Blocking screws are useful adjuncts to stabilise the nail in the desired location.…”

PRECICE intramedullary limb lengthening system

“…Therefore, reduction in unplanned secondary surgery will significantly increase the cost-effectiveness of the PRECICE method. ) conducted a retrospective, single-center study to report the early results of the PRECICE system, based on the experience of three surgeons at a single center [19]. Institutional Review Board approval was obtained for this study.…”