What Is a Bone Length Discrepancy?
Our service is dedicated to correcting limb length discrepancies through bone regeneration. A limb length discrepancy (LLD) is defined as one arm or leg shorter in length than the other. It can affect the entire limb or just part of it. LLDs are very common, and many people have a small difference in leg or arm length that they don’t even notice and doesn’t need treatment. However, as discrepancy increases over 1cm or ½ in, it becomes increasingly problematic, especially in the legs. Unequal leg lengths can lead to pain in the low back, hips and knees, and correction is generally recommended.
How Are Bones Lengthened?
Bone lengthening starts with a controlled break in the bone, which is then slowly pulled apart, allowing the bone to partially heal as it gets longer. When the final distance is reached and the bone fully heals, the limb is longer and made of the same bone as the rest of the body. Pulling the bone apart can be achieved with external devices, like ringed external fixators or simple linear rails, or with internal lengthening nails. While multiple lengthening nails exist, we primarily use a magnetically driven device called the Precice nail.
What is The Precice Nail?
The Precice nail is a telescopic metal rod with a gear system and magnet that’s inserted into the center of the bone during surgery. The bone is divided by an osteotomy, and the nail is secured in place with screws. After surgery, a patient is given a handheld External Remote Controller (ERC) that has a rotating magnet inside. The ERC can be used to slowly lengthen the nail by making the magnet spin. The ERC is customizable to each patient’s needs and can be used at home.
How Much Additional Length Can Be Achieved?
The Precice nail can be used to lengthen the femur, tibia, or humerus up to 8 centimeters (lengthening the forearm still requires external fixation). Lengthening surgery with internal expandable nails is considered accurate, safe, and more comfortable for patients than external fixation methods. It has a low complication rate and high patient satisfaction rate.
Femur Lengthening Before and After Images
Tibia Lengthening Before and After Images
Upper ExtremityLengthening Before and After Images
Videos
Ruslan demonstrates use of remote control to lengthen femur and tibia using #precicenail #leglengthening for 8 cm #leglengthdiscrepancy #limblengthdiscrepancy #Rozbruch #aaos #llrs #orthopedicsurgery #liveyourbestlife @all4ortho #orthopedicsurgeon #hospitalforspecialsurgery #limblengthening @hspecialsurgery @limbdeformity @reifmd #SRobertRozbruchMD www.limblengthening.com www.hss.edu/limblengthening www.hss.edu/LSARC #hssLLCRS #HSSlimbLengthening
Odegoke had #limblengtheningsurgery distal to #hipreplacement We see patients who have leg length discrepancy, following or related to a hip replacement. This can be corrected with a limb lengthening surgery below the hip replacement. #precicenail #Rozbruch #aaos #llrs #orthopedicsurgery #liveyourbestlife @all4ortho #orthopedicsurgeon #hospitalforspecialsurgery #limblengthening @hspecialsurgery @limbdeformity @reifmd #SRobertRozbruchMD www.limblengthening.com www.hss.edu/limblengthening www.hss.edu/LSARC #hssLLCRS #HSSlimbLengthening
Rosanna from Dominican Republic after femur limb lengthening to correct deformity and #leglengthdiscrepancy with #precicenail She grew healthy bone at age 65! #Rozbruch #aaos #llrs #orthopedicsurgery #liveyourbestlife @all4ortho #orthopedicsurgeon #hospitalforspecialsurgery #limblengthening @hspecialsurgery @limbdeformity @reifmd #SRobertRozbruchMD www.limblengthening.com www.hss.edu/limblengthening www.hss.edu/LSARC #hssLLCRS #HSSlimbLengthening
This patient (and a neighbor!) presented with a short bowed leg as well as a very malpositioned tibial tubercle, so the knee cap slid down the middle of her knee instead of the front! This is both uncomfortable and significantly compromises the strength needed to straighten the leg.
To address these concerns, she required an osteotomy to straighten and lengthen and another adjacent osteotomy to fix the tubercle. It’s a lot of surgery all in one area, so scar tissue is a real concern, but she did an amazing job with PT and has full knee motion and strength today!
Given positive cat feedback, here is our other cat 🐈⬛.
#hssllcrs #hsslimblengthening #precicenail #osteotomy #bowleg #limblengthening #bone #bonelengthening #orthopedics #tibia #orthopedicsurgery #bonedeformity #deformity
Alex after one inch femur #leglengtheningsurgery with #precicenail done for #leglengthdiscrepancy #limblengthdiscrepancy #hsskids #pediatricorthopedics #Rozbruch #aaos #llrs #orthopedicsurgery #liveyourbestlife @all4ortho #orthopedicsurgeon #hospitalforspecialsurgery #limblengthening @hspecialsurgery @limbdeformity @reifmd #SRobertRozbruchMD www.limblengthening.com www.hss.edu/limblengthening www.hss.edu/LSARC #hssLLCRS #HSSlimbLengthening
Last week I had the opportunity to speak at the 6th World Congress for ASAMI and ILLRS on topics of #limbtrauma , #limblengthening , #precice #precicenail , and #osseointegratıon . Glad to have spoken with my partner and mentor @limblengthening and our recent research fellow @jida_wanderer
This is how Mr A felt regarding his counseling and care experience with me regarding his #limblengthening with the #precicenail . For many patients, having the awareness or the confidence is the most important hurdle.
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#all4ortho #hssllcrs #hsslimblengthening #hspecialsurgery
This is an interim story for Mr A, who had a left femur #limbtrauma causing a limb length difference of 33 mm which was addressed with a #limblengthening #precicenail . Here is how I counseled him for care prior to surgery. Before surgery he had a limp and leaned down when he walked. Today he began full weight bearing. He will benefit from PT gait training, but already has a better balanced gait.
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#all4ortho #hssllcrs #hsslimblengthening #hspecialsurgery
