Acute deformity correction and lengthening using the PRECICE magnetic intramedullary lengthening nail
Background: External fixators have been used to treat patients with limb length discrepancy with deformity. Implantable intramedullary (IM) lengthening nails are an attractive alternative achieving accurate results with fewer complications than external fixators. We report on PRECICE™ nail utilizati...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2020-01-01
|
| Series: | Journal of Limb Lengthening & Reconstruction |
| Subjects: | |
| Online Access: | http://www.jlimblengthrecon.org/article.asp?issn=2455-3719;year=2020;volume=6;issue=1;spage=20;epage=27;aulast=Hammouda |
| _version_ | 1818154964402307072 |
|---|---|
| author | Ahmed I Hammouda Vivian L Szymczuk Martin G Gesheff Nequesha S Mohamed Janet D Conway Shawn C Standard Philip K McClure John E Herzenberg |
| author_facet | Ahmed I Hammouda Vivian L Szymczuk Martin G Gesheff Nequesha S Mohamed Janet D Conway Shawn C Standard Philip K McClure John E Herzenberg |
| author_sort | Ahmed I Hammouda |
| collection | DOAJ |
| description | Background: External fixators have been used to treat patients with limb length discrepancy with deformity. Implantable intramedullary (IM) lengthening nails are an attractive alternative achieving accurate results with fewer complications than external fixators. We report on PRECICE™ nail utilization for simultaneous lower limb lengthening and acute deformity correction. Materials and Methods: A retrospective institutional study included a total of 22 segments (13 femurs, 9 tibias; mean age = 17 years) that underwent simultaneous acute deformity correction and lengthening using fixator-assisted nailing and the PRECICE™ IM nail between 2012 and 2015. Results: All segments were corrected with mean final mechanical axis deviation 0.8 cm (0–2.0 cm). Femoral segments achieved frontal plane correction from a preoperative mean lateral distal-femoral angle of 86° to a postoperative mean of 89°; and a sagittal plane correction from a preoperative mean posterior distal femoral angle of 76° to a postoperative mean of 84°. Tibial segments achieved frontal plane correction from a preoperative mean medial proximal tibial angle of 94° to a postoperative mean of 89°; and a sagittal plane correction from a preoperative mean posterior proximal tibial angle of 72° to a postoperative mean of 79°. Rotational malalignment was corrected in all cases based on clinical examination of the rotational profile. The mean length achieved was 4.7 cm. One femoral segment (4.5%) did not achieve the lengthening goal. The mean consolidation index was 42 days/cm. Mean distraction index was 0.7 days/mm. Conclusions: Internal lengthening can permit both lengthening and acute deformity correction, with appropriate preoperative planning, using fixator assisted nailing techniques. |
| first_indexed | 2024-12-11T14:34:52Z |
| format | Article |
| id | doaj.art-6a514ed008bf4a40821794956b5412d6 |
| institution | Directory Open Access Journal |
| issn | 2455-3719 2455-3719 |
| language | English |
| last_indexed | 2024-12-11T14:34:52Z |
| publishDate | 2020-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Limb Lengthening & Reconstruction |
| spelling | doaj.art-6a514ed008bf4a40821794956b5412d62022-12-22T01:02:14ZengWolters Kluwer Medknow PublicationsJournal of Limb Lengthening & Reconstruction2455-37192455-37192020-01-0161202710.4103/jllr.jllr_6_20Acute deformity correction and lengthening using the PRECICE magnetic intramedullary lengthening nailAhmed I HammoudaVivian L SzymczukMartin G GesheffNequesha S MohamedJanet D ConwayShawn C StandardPhilip K McClureJohn E HerzenbergBackground: External fixators have been used to treat patients with limb length discrepancy with deformity. Implantable intramedullary (IM) lengthening nails are an attractive alternative achieving accurate results with fewer complications than external fixators. We report on PRECICE™ nail utilization for simultaneous lower limb lengthening and acute deformity correction. Materials and Methods: A retrospective institutional study included a total of 22 segments (13 femurs, 9 tibias; mean age = 17 years) that underwent simultaneous acute deformity correction and lengthening using fixator-assisted nailing and the PRECICE™ IM nail between 2012 and 2015. Results: All segments were corrected with mean final mechanical axis deviation 0.8 cm (0–2.0 cm). Femoral segments achieved frontal plane correction from a preoperative mean lateral distal-femoral angle of 86° to a postoperative mean of 89°; and a sagittal plane correction from a preoperative mean posterior distal femoral angle of 76° to a postoperative mean of 84°. Tibial segments achieved frontal plane correction from a preoperative mean medial proximal tibial angle of 94° to a postoperative mean of 89°; and a sagittal plane correction from a preoperative mean posterior proximal tibial angle of 72° to a postoperative mean of 79°. Rotational malalignment was corrected in all cases based on clinical examination of the rotational profile. The mean length achieved was 4.7 cm. One femoral segment (4.5%) did not achieve the lengthening goal. The mean consolidation index was 42 days/cm. Mean distraction index was 0.7 days/mm. Conclusions: Internal lengthening can permit both lengthening and acute deformity correction, with appropriate preoperative planning, using fixator assisted nailing techniques.http://www.jlimblengthrecon.org/article.asp?issn=2455-3719;year=2020;volume=6;issue=1;spage=20;epage=27;aulast=Hammoudaacute deformity correctionbone lengtheningintramedullary nail |
| spellingShingle | Ahmed I Hammouda Vivian L Szymczuk Martin G Gesheff Nequesha S Mohamed Janet D Conway Shawn C Standard Philip K McClure John E Herzenberg Acute deformity correction and lengthening using the PRECICE magnetic intramedullary lengthening nail Journal of Limb Lengthening & Reconstruction acute deformity correction bone lengthening intramedullary nail |
| title | Acute deformity correction and lengthening using the PRECICE magnetic intramedullary lengthening nail |
| title_full | Acute deformity correction and lengthening using the PRECICE magnetic intramedullary lengthening nail |
| title_fullStr | Acute deformity correction and lengthening using the PRECICE magnetic intramedullary lengthening nail |
| title_full_unstemmed | Acute deformity correction and lengthening using the PRECICE magnetic intramedullary lengthening nail |
| title_short | Acute deformity correction and lengthening using the PRECICE magnetic intramedullary lengthening nail |
| title_sort | acute deformity correction and lengthening using the precice magnetic intramedullary lengthening nail |
| topic | acute deformity correction bone lengthening intramedullary nail |
| url | http://www.jlimblengthrecon.org/article.asp?issn=2455-3719;year=2020;volume=6;issue=1;spage=20;epage=27;aulast=Hammouda |
| work_keys_str_mv | AT ahmedihammouda acutedeformitycorrectionandlengtheningusingtheprecicemagneticintramedullarylengtheningnail AT vivianlszymczuk acutedeformitycorrectionandlengtheningusingtheprecicemagneticintramedullarylengtheningnail AT martinggesheff acutedeformitycorrectionandlengtheningusingtheprecicemagneticintramedullarylengtheningnail AT nequeshasmohamed acutedeformitycorrectionandlengtheningusingtheprecicemagneticintramedullarylengtheningnail AT janetdconway acutedeformitycorrectionandlengtheningusingtheprecicemagneticintramedullarylengtheningnail AT shawncstandard acutedeformitycorrectionandlengtheningusingtheprecicemagneticintramedullarylengtheningnail AT philipkmcclure acutedeformitycorrectionandlengtheningusingtheprecicemagneticintramedullarylengtheningnail AT johneherzenberg acutedeformitycorrectionandlengtheningusingtheprecicemagneticintramedullarylengtheningnail |