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

摘要

BACKGROUND : Limb lengthening is performed through distraction osteogenesis after osteotomy and hastraditionally been performed using external fixation. The PRECICE® Limb Lengthening System has recentlyemerged as an alternative method to control distraction. In this study, the first experience of intramedullary naillengthening using PRECICE®, in a South African limb lengthening and reconstruction unit, was evaluated interms 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 ofthe nail was initiated by ERC (external remote controller) around 10 days after surgery at a distraction rate of1 mm/day. The distraction was monitored every 2 weeks by clinical and radiographic examinations. Ongoingphysiotherapy 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 followupperiod of 266 days, with an accuracy of 103% ± 18%. All the distraction segments united. Two complicationswere reported that were successfully treated.CONCLUSION : Limb lengthening using the PRECICE® nail system was found to have excellent accuracy ofdistraction, which is reproducible between different segments and indications. Acceptable complication rateswere observed in this study.