Yonsei Kim And Chung Orthopedic Clinic combines the professionalism of doctors who have performed more than 30,000 joint and deformity surgeries, minimally invasive surgical procedures and high level limb lengthening and deformity correction surgeries.
Limb lengthening surgery is a specialized orthopedic procedure that increases the length of bones in the arms or legs to correct limb length discrepancies, address deformities, or, in some cases, for cosmetic reasons. Advances in medical technology have made this surgery more precise and less invasive, offering patients improved outcomes and shorter recovery times.
Limb lengthening surgery involves cutting a bone (osteotomy) and gradually separating the two segments to allow new bone to grow in the space between. This process, known as distraction osteogenesis, stimulates natural bone regeneration, with new bone tissue filling in the gap. Limb lengthening can be performed on the femur (thighbone), tibia (shinbone), humerus (upper arm), or other long bones, depending on the patient’s needs.
Lengthening Over Nail (LON) is a surgical technique used in orthopedic surgery for limb lengthening, particularly in cases where patients require an increase in bone length due to conditions such as limb length discrepancies, dwarfism, or other congenital or acquired deformities. This technique combines the benefits of external fixation and an intramedullary nail, allowing for gradual bone lengthening while reducing complications often associated with prolonged external fixation. Here’s a closer look at the procedure, benefits, challenges, and post-operative care associated with the LON technique.
The LON technique involves the use of an external fixator to gradually lengthen the bone, with the addition of an intramedullary nail that stabilizes the bone internally as lengthening progresses. Initially, the external fixator is applied to the limb, and the bone is surgically cut in a controlled way (a process called osteotomy). The bone segments are gradually separated, allowing new bone tissue to form in the gap—a process called distraction osteogenesis. The nail is inserted within the bone’s marrow cavity to provide internal support, and once the desired length is achieved, the external fixator is removed, leaving only the nail to stabilize the bone as it consolidates.
Reduced External Fixation Time: The intramedullary nail supports the bone as it consolidates, significantly reducing the time the patient needs to wear the external fixator.
Increased Stability and Reduced Pain: The nail provides internal stability, which decreases the likelihood of misalignment and reduces pain compared to external fixation alone.
Enhanced Mobility and Comfort: Patients typically find it easier to move around once the external fixator is removed, as the internal nail offers support without the bulk and discomfort of the external device.
Lower Infection Risk: Since the external fixator can be removed earlier, the risk of pin-tract infections—a common issue with prolonged external fixation—is reduced.
The Lengthening Over Nail (LON) technique offers a hybrid approach to limb lengthening, blending the gradual, controlled process of external fixation with the stability of an intramedullary nail. This method shortens the period of external fixation, reduces discomfort, and enhances patient mobility during the recovery process. With careful patient selection, meticulous surgical technique, and dedicated post-operative care, LON has become an effective solution for many individuals seeking limb lengthening or correction for limb discrepancies.
The PRECICE Lengthening System consists of a telescoping metal rod with a magnetic motor inside of it and the External Remote Controller (ERC). The internal nail is inserted through a small incision into the bone marrow cavity, and a patient lengthens the bone with the external remote controller.
The PRECICE Intramedullary Limb Lengthening System is an advanced medical device designed to address limb length discrepancies by gradually lengthening long bones such as the femur and tibia. Developed by NuVasive Specialized Orthopedics, this system offers a less invasive alternative to traditional external fixation methods, enhancing patient comfort and reducing the risk of complications.
Magnetic Mechanism: The system utilizes a telescopic intramedullary nail with an internal magnetic mechanism. An External Remote Controller (ERC) is used to non-invasively adjust the nail, allowing for precise control over the lengthening process.
Indications for Use: The PRECICE system is intended for limb lengthening, open and closed fracture fixation, pseudarthrosis, malunions, nonunions, or bone transport of long bones in patients aged 18 years and older. It is also indicated for limb lengthening of the femur and tibia in pediatric patients over 12 years old.
Patient Benefits: Compared to traditional external fixators, the PRECICE system offers improved patient comfort, reduced risk of infection, and enhanced cosmetic outcomes due to the internal placement of the device. Additionally, it allows for precise control over the rate and amount of lengthening, which can be adjusted based on individual patient needs.
The PRECICE Intramedullary Limb Lengthening System represents a significant advancement in orthopedic surgery, offering a more patient-friendly approach to limb lengthening with precise control and reduced complications compared to traditional methods.
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