Strategies in Trauma and Limb Reconstruction

Register      Login

VOLUME 14 , ISSUE 3 ( September-December, 2019 ) > List of Articles

Original Article

Electromagnetic Rod in Lower Limb Lengthening: A Technical Note for Shaft Osteotomy

Miguel Lopes, Bernardo Nunes, André Couto, Joana Freitas, Rui Martins, Jorge Coutinho, Gilberto Costa

Keywords : Lengthening nail, Limb deformity, Limb lengthening

Citation Information : Lopes M, Nunes B, Couto A, Freitas J, Martins R, Coutinho J, Costa G. Electromagnetic Rod in Lower Limb Lengthening: A Technical Note for Shaft Osteotomy. 2019; 14 (3):139-141.

DOI: 10.5005/jp-journals-10080-1444

License: CC BY-NC-SA 4.0

Published Online: 03-09-2020

Copyright Statement:  Copyright © 2019; The Author(s).


Abstract

Purpose: Long bone lengthening procedures are paramount in the treatment of limb length discrepancies. We witnessed a revolution in the treatment paradigm of this pathology with the development of expandable intramedullary rods. Endomedular nailing might be technically demanding and some steps are critical for success. The aim of authors is to describe a technical note of the PRECICE system that may ease femoral nailing and fixation: the nail can be advanced through the femur and proximal and distal fixation performed previous to complete femoral osteotomy. Materials and methods: The authors present a case series of XX patients in which the limb lengthening has been performed with partial osteotomy with Gigli saw, nail advancement, proximal and distal fixation, and osteotomy completion at the end of the procedure. Results: After 18 consecutive limb (femoral) lengthening operations with this technical variation in PRECICE, nail patients presented no significant lower limb length discrepancy. There were no records of rotational deformities, nonunion, or infection. Material failure was not reported. Conclusion: This technical note is another positive variable that can help to ease the procedure, minimise possible complications, and confirm magnetic expandable nails as the gold standard technique in limb lengthening procedures and it might be applied to other nailing systems for limb lengthening procedures.


HTML PDF Share
  1. Calder PR, Laubscher M, Goodier WD. The role of the intramedullary implant in limb lengthening. Injury 2017;48(Suppl 1):S52–S58. DOI: 10.1016/j.injury.2017.04.028.
  2. Kirane YM, Fragomen AT, Rozbruch SR. Precision of the PRECICE internal bone lengthening nail. Clin Orthop 2014;472(12):3869. DOI: 10.1007/s11999-014-3575-0.
  3. Paley D, Harris M, Debiparshad K, et al. Limb lengthening by implantable lengthening devices. Tech Orthop 2014;29(2):72. DOI: 10.1097/BTO.0000000000000072.
  4. Schiedel FM, Vogt B, Tretow HL, et al. How precise is the PRECICE compared to the ISKD in intra-medullary limb lengthening? Acta Orthop 2014;85(3):293. DOI: 10.3109/17453674.2014.913955.
  5. Burghardt RD, Paley D, Specht SC, et al. The effect on mechanical axis deviation of femoral lengthening with an intramedullary telescopic nail. J Bone Joint Surg Br 2012;94(9):1241–1245. DOI: 10.1302/0301-620X.94B9.28672.
  6. Muthusamy S, Rozbruch SR, Fragomen AT. The use of blocking screws with internal lengthening nail and reverse rule of thumb for blocking screws in limb lengthening and deformity correction surgery. Strategies Trauma Limb Reconstruction 2016;11(3):199–205. DOI: 10.1007/s11751-016-0265-3.
  7. Birch J. A brief history of limb lengthening. J Pediatr Orthop 2017;37(Suppl 2):S1–S8. DOI: 10.1097/BPO.0000000000001021.
  8. Calder P, McGrath A, Chasseaud M, et al. The PRECICE intramedullary limb lengthening system. Bone Joint J 2013;95-B(Suppl. 23):11.
  9. Xu WG. Comparison of intramedullary nail versus conventional Ilizarov method for lower limb lengthening: a systematic review and meta analysis. Orthop Surg 2017;9(2):159–166. DOI: 10.1111/os.12330.
  10. Laubscher M, Mitchell C, Timms A, et al. Outcomes following femoral lengthening: an initial comparison of the PRECICE intramedullary lengthening nail and the LRS external fixator monorail system. Bone Joint J 2016;98-B(10):1382–1388. DOI: 10.1302/0301-620X.98B10.36643.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.