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What is Limb Lengthening with the PRECICE® System?

Limb Lengthening with the PRECICE® System is an intramedullary limb lengthening device comprised of implantable screws and nails with a hand-held External Remote Controller. The device is designed to lengthen the thigh bone (femur) or the shin bone (tibia) with precision and control for the treatment of leg lengthening.

The PRECICE® System is the most recent and state-of-the-art internal limb lengthening device that is inserted into the intramedullary canal (center) of the affected bones. It utilizes a magnetically controlled intramedullary lengthening nail that enables controlled lengthening of the long bones without the need for external wires or pins.

Working Mechanism of the PRECICE® System

Limb lengthening with the PRECICE® System is comprised of a telescopic metal rod called a lengthening nail which has a magnetic motor inside it. This nail is placed into the bone canal where the bone marrow is found through a small surgical cut. The patient is given an innovative control called an External Remote Controller (ERC) that consists of a rotating magnet within it. When the ERC is positioned against the limb and turned on, the magnetic movement within the ERC prompts the magnetic motor within the PRECICE system to slowly lengthen the nail. When the PRECICE nail lengthens, it causes the bone to also lengthen accordingly.

Benefits of Limb Lengthening with the PRECICE® System

Some of the important benefits of limb lengthening with the PRECICE® System include:

  • Minimally invasive procedure
  • Eliminates the need for an external fixation device
  • Regenerates and stimulates bone growth
  • Reversible device
  • Customizable based on patient’s prescription

Preparation for Limb Lengthening with the PRECICE® System

Pre-operative preparation for limb lengthening with the PRECICE® System will involve the following steps:

  • A thorough examination is performed by Dr. Kane.
  • Depending on your medical history, social history, and age, you may need to undergo tests such as blood work and imaging to help detect any abnormalities that could threaten the safety of the procedure.
  • You will be asked if you have allergies to medications, anesthesia, or latex.
  • You should inform your doctor and/or nurse of any medications, vitamins, or supplements that you are taking.
  • You should refrain from medications or supplements such as blood thinners, aspirin, or anti-inflammatory medicines for 1 to 2 weeks prior to surgery.
  • You should not consume any solids or liquids at least 8 hours prior to surgery.
  • A written consent will be obtained from you after the surgical procedure has been explained in detail.

Procedure for Limb Lengthening with the PRECICE® System

Surgery for placement of the PRECICE® System is usually performed under general anesthesia and involves the following steps:

  • After adequately sterilizing the surgical area, Dr. Kane makes an incision over the outside of the affected long bone (femur or tibia).
  • The supporting structures around the bone are gently moved out of the way to prepare the surface of the bone for the PRECICE® System placement.
  • Dr. Kane makes a cut above and below the affected bone and inserts the PRECICE nail inside the intramedullary canal of the affected bone.
  • Screws are placed above and below the bone to hold the device in place.
  • All surrounding tissues and structures are restored to their normal anatomic position.
  • Finally, the incision is closed with sutures and sterile dressings are applied.
  • About 7 to 10 days after the PRECICE nail insertion, the external motorized magnetic remote-control device is placed on the leg for about 3 to 4 minutes, 4 times a day. This enables controlled lengthening of the rod and bone.

Postoperative Care and Recovery

In general, postoperative care instructions and recovery will involve the following steps:

  • You will be transferred to the recovery area to be monitored until you are awake from the anesthesia.
  • The nurse will monitor your blood oxygen level and other vital signs as you recover.
  • You may notice some pain, swelling, and discomfort in the operated area. Pain and anti-inflammatory medications are provided as needed.
  • Medications may also be prescribed as needed for symptoms associated with anesthesia, such as vomiting and nausea.
  • Antibiotics are prescribed to address the risk of surgery-related infection.
  • Keep the surgical sites clean and dry. Instructions on surgical site care and bathing will be provided.
  • You are encouraged to walk with assistance as frequently as possible to prevent the risk of blood clots.
  • Eating a healthy diet rich in vitamin D is strongly advised to promote healing and a faster recovery.
  • You should refrain from strenuous activities and lifting heavy weights for the first couple of months. Gradual increase in activities over a period of time is recommended.
  • A physical therapy protocol is strongly recommended to help strengthen muscles and optimize joint function.
  • Most patients can resume normal activities within 2 to 3 weeks with certain activity restrictions.
  • Periodic follow-up appointments will be scheduled to monitor your progress.

Risks and Complications

Limb lengthening with the PRECICE® System is a relatively safe procedure; however, as with any surgical procedure, it does carry some risks and complications, including:

  • Blood clots
  • Infection
  • Bleeding
  • Injury to nerves and blood vessels
  • Anesthetic-related complications
  • Device breakage
  • Insufficient lengthening
  • Revision surgery