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Limb Lengthening Using the PRECICE(TM) Nail System: Complications and Results
BACKGROUND: Three 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 clinic...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Kowsar
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5253187/ https://www.ncbi.nlm.nih.gov/pubmed/28144605 http://dx.doi.org/10.5812/atr.36273 |
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author | Wiebking, Ulrich Liodakis, Emmanouil Kenawey, Mohamed Krettek, Christian |
author_facet | Wiebking, Ulrich Liodakis, Emmanouil Kenawey, Mohamed Krettek, Christian |
author_sort | Wiebking, Ulrich |
collection | PubMed |
description | BACKGROUND: Three 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 PRECICE(TM) nail (Ellipse, USA). OBJECTIVES: The aim of the current study was to describe and analyze the complications associated with lengthening with the PRECICE(TM) nail. Are the problems preventable when using the PRECICE, related to the distraction rate control, the lengthening goals and technique and handling? METHODS: We retrospectively reviewed the charts of 9 patients operated between 2012 and 2013 with a PRECICE(TM) 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). RESULTS: The 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. CONCLUSIONS: We 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. |
format | Online Article Text |
id | pubmed-5253187 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Kowsar |
record_format | MEDLINE/PubMed |
spelling | pubmed-52531872017-01-31 Limb Lengthening Using the PRECICE(TM) Nail System: Complications and Results Wiebking, Ulrich Liodakis, Emmanouil Kenawey, Mohamed Krettek, Christian Arch Trauma Res Research Article BACKGROUND: Three 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 PRECICE(TM) nail (Ellipse, USA). OBJECTIVES: The aim of the current study was to describe and analyze the complications associated with lengthening with the PRECICE(TM) nail. Are the problems preventable when using the PRECICE, related to the distraction rate control, the lengthening goals and technique and handling? METHODS: We retrospectively reviewed the charts of 9 patients operated between 2012 and 2013 with a PRECICE(TM) 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). RESULTS: The 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. CONCLUSIONS: We 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. Kowsar 2016-08-23 /pmc/articles/PMC5253187/ /pubmed/28144605 http://dx.doi.org/10.5812/atr.36273 Text en Copyright © 2016, Kashan University of Medical Sciences http://creativecommons.org/licenses/by-nc/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited. |
spellingShingle | Research Article Wiebking, Ulrich Liodakis, Emmanouil Kenawey, Mohamed Krettek, Christian Limb Lengthening Using the PRECICE(TM) Nail System: Complications and Results |
title | Limb Lengthening Using the PRECICE(TM) Nail System: Complications and Results |
title_full | Limb Lengthening Using the PRECICE(TM) Nail System: Complications and Results |
title_fullStr | Limb Lengthening Using the PRECICE(TM) Nail System: Complications and Results |
title_full_unstemmed | Limb Lengthening Using the PRECICE(TM) Nail System: Complications and Results |
title_short | Limb Lengthening Using the PRECICE(TM) Nail System: Complications and Results |
title_sort | limb lengthening using the precice(tm) nail system: complications and results |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5253187/ https://www.ncbi.nlm.nih.gov/pubmed/28144605 http://dx.doi.org/10.5812/atr.36273 |
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