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

Abstract

BACKGROUND : Limb lengthening is performed through distraction osteogenesis after osteotomy and has traditionally been performed using external fixation. The PRECICE® Limb Lengthening System has recently emerged as an alternative method to control distraction. In this study, the first experience of intramedullary nail lengthening using PRECICE®, in a South African limb lengthening and reconstruction unit, was evaluated in terms of the accuracy of distraction and the number of implant-related complications that were reported. METHODS : A total of nine patients underwent the limb lengthening procedure in 11 limb segments. Distraction of the nail was initiated by ERC (external remote controller) around 10 days after surgery at a distraction rate of 1 mm/day. The distraction was monitored every 2 weeks by clinical and radiographic examinations. Ongoing physiotherapy rehabilitation was performed until consolidation was achieved. RESULTS : A mean target distraction length of 45.18 mm (15 to 65 mm range) was obtained over an average followup period of 266 days, with an accuracy of 103% ± 18%. All the distraction segments united. Two complications were reported that were successfully treated. CONCLUSION : Limb lengthening using the PRECICE® nail system was found to have excellent accuracy of distraction, which is reproducible between different segments and indications. Acceptable complication rates were observed in this study.