Limb lengthening with fully implantable magnetically actuated mechanical nails (PHENIX®)—Preliminary results

Thaller, Peter Helmut; Fürmetz, Julian; Wolf, Florian; Eilers, T.; Mutschler, Wolf

doi:10.1016/j.injury.2013.10.029

Cited by 61 publications

(43 citation statements)

References 22 publications

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“…Phenix and PRECICE nails are magnetically motorised rods capable of lengthening and shortening long bones [20,25]. Rod-length increase or decrease occurs in response to a portable external remote controller (ERC) placed superficially on the skin [31].…”

Section: Internal Lengthening Rodsmentioning

confidence: 99%

“…Satisfactory preliminary outcomes were reported in Europe with Phenix M2 nail system, which has both lengthening and shortening modes. Researchers used the shortening option on one occasion for distraction-induced neurological deficit of the foot, which recovered eventually [25]. Likewise, shortening may help ameliorate other distraction-related complications, such as joint subluxation and progressive soft tissue contractures.…”

Section: Compressionmentioning

confidence: 99%

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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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Section: Internal Lengthening Rodsmentioning

confidence: 99%

Section: Compressionmentioning

confidence: 99%

Use of internal lengthening nails in post-traumatic sequelae

Alrabai

Gesheff

Conway

2017

International Orthopaedics (SICOT)

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“…In addition, patient comfort and joint mobility have increased (1-6). On the other hand, the general risk of incomplete bone regeneration and pseudoarthrosis with the associated risk of material failure and falling short of the lengthening goal persists.…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, the general risk of incomplete bone regeneration and pseudoarthrosis with the associated risk of material failure and falling short of the lengthening goal persists. Secondary surgical procedures to achieve healing and/or the lengthening goal again put the advantages of the internal implantation into perspective (6, 7). …”

Section: Introductionmentioning

confidence: 99%

Limb Lengthening Using the PRECICETM Nail System: Complications and Results

et al. 2016

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BackgroundThree types of telescopic nails are mainly used for intramedullary limb lengthening nowadays. Despite some important advantages of this new technology (e.g. controlled distraction rate, not restricted availability, possibility to perform accordion maneuvers), few articles exist on clinical results and complications after lengthening with the PRECICETM nail (Ellipse, USA).ObjectivesThe aim of the current study was to describe and analyze the complications associated with lengthening with the PRECICETM nail. Are the problems preventable when using the PRECICE, related to the distraction rate control, the lengthening goals and technique and handling?MethodsWe retrospectively reviewed the charts of 9 patients operated between 2012 and 2013 with a PRECICETM nail for a leg length discrepancy (LLD). The mean age of the patients was 32 years (range, 17 - 48 years). There were 5 femoral and 4 tibial procedures. The causes of LLD were posttraumatic (n = 5) and congenital (n = 4). The mean LLD was 36.4 ± 11.4 mm. The minimum follow-ups were 2 months (average, 5 months; range, 2 - 9 months).ResultsThe mean distraction rate was 0.5 ± 0.1 mm/day. We observed in 7 patients differences in achieving the lengthening goals (average, 1.6 mm; range, -20.0 - 5.0 mm). Average lengthening was 34.7 ± 10.7 mm. All patients reached normal alignment and normal joint orientation. An unintentional loss of the achieved length during the consolidation phase was noticed in patients with delayed bone healing in two cases. In the first case (loss of 20mm distraction) the nail could be redistracted and the goal length was achieved. In the second case (loss of 10mm distraction) the nail broke shortly after the diagnosis and the nail was exchanged.ConclusionsWe report of loss of achieved length after lengthening with a telescopic nail. Weight bearing before complete consolidation of the regenerate might be a risk factor for that. Thorough examination of the limb length and careful evaluation of the radiographs are required in the follow-up period. The PRECICE nail system requires the same vigilance like the other intramedullary systems too.

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“…The clinical results are highly encouraging, but lengthening failures and most particularly excessively rapid gains in length have been reported [28]. The current trend is the development of implants allowing passive lengthening, with either motorized (Fitbone nail) or magnetic (Phenix and Precice nails) devices, but these fairly rare and expensive techniques are still in the evaluation phase [29,30]. In the postinfectious context, a prior study of the medullary cavity will always be necessary, because modifications in its diameter can make nailing difficult, as will an assessment of the risk of reactivating infection, given the risk of pandiaphysitis with material that has an uncertain prognosis, and an evaluation of the mobility, quality (chondrolysis?…”

Section: Lateral Epiphysiodesismentioning

confidence: 99%

Sequelae of pediatric osteoarticular infection

Ilharreborde

2015

Orthopaedics & Traumatology: Surgery & Research

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The epidemiology and diagnosis of osteoarticular infections (OAI) have changed considerably in recent years, partly due to the development of molecular biology. Kingella kingae is now recognized as the most frequent pathogen in children under 4 years of age, while methicillin-resistant Staphylococcus aureus (SA) has been increasingly reported. Although the clinical course of OAI is mostly benign, with shorter antibiotic regimens and simplified treatments, serious functional impairments and life-threatening complications can still occur, especially in case of delayed diagnosis or infection caused by Panton-Valentine leukocidin-producing strains of SA. Newborns and patients with sickle cell disease have greater risk of orthopaedic sequelae, which need to be detected and managed early. The main sequelae of osteomyelitis are angular limb deformity, due to partial growth arrest, and lower limb discrepancy. Therapeutic options are guided by the patient's age and predictions at maturity. The main complications of septic arthritis are joint stiffness and osteonecrosis. The procedures to consider are arthrodesis, joint reconstruction in immature children, and arthroplasty at the end of growth.

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Limb lengthening with fully implantable magnetically actuated mechanical nails (PHENIX®)—Preliminary results

Cited by 61 publications

References 22 publications

Use of internal lengthening nails in post-traumatic sequelae

Use of internal lengthening nails in post-traumatic sequelae

Limb Lengthening Using the PRECICETM Nail System: Complications and Results

Sequelae of pediatric osteoarticular infection

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