What Is a Bone Length Discrepancy?
Our service is dedicated to correcting limb length discrepancies through limb lengthening surgery, which causes 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 limb lengthening surgery called 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). Limb 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 Extremity Lengthening Before and After Images
Videos
This is a pretty good animation that shows the process of #leglengthening with #precicenail #limblengthening although our incisions are more much smaller and in most cases the nail goes inside the marrow cavity of the bone. #hssllcrs #hsslimblengthening @hspecialsurgery @limblengtheningreconstruction @all4ortho @limbdeformity @reifmd
Logan, an impressive young man is blind and autistic and is a brilliant pianist and huge fan of @andreabocelliofficial I performed a 5 cm #limblengtheningsurgery #precicenail #hssllcrs #hsslimblengthening @hspecialsurgery @limblengtheningreconstruction
Lucas from Iowa with #russellsilversyndrome was treated for #leglengthdiscrepancy with #precicenail Now all done and rod has been removed. Big improvement in function and body image and confidence #hsskids #hssllcrs @hspecialsurgery @limblengtheningreconstruction @ellekashmedia I appreciate his gratitude!
Great mobility and bone after #staturelengthening #precicenail was used and has been removed. Precice Max is here and allows improved mobility after surgery. #hssllcrs #hsslimblengthening @hspecialsurgery @limblengtheningreconstruction @ellekashmedia
This is a really well done animation @thebrainmaze of #hsslimblengthening #leglengthening with #precicenail internal motorized lengthening nail showing how the bone is lengthened and then grows to be strong bone. #hssllcrs @hspecialsurgery @limblengtheningreconstruction
Shalon had a tibia #precicenail #hsslimblengthening for #leglengthdiscrepancy Adults can grow healthy bone and the most important strategy is to lengthen at a slow speed. #hssllcrs @hspecialsurgery @limblengtheningreconstruction
#precicenail #precicemax is at @hspecialsurgery and is stronger than the previous lengthening nails. This will allow more weight bearing and a faster and safer recovery. We are also collaborating with the HSS Metabolic Bone Department to enhance bone growth with parathyroid hormone, Vitamin D3, Calcium and other nutritional supplements to get you mobilized and healed ASAP. #hssllcrs #hsslimblengthening #staturelengthening @limblengtheningreconstruction
Viktor and his mom from Singapore. After a traumatic amputation at a very young age, he had a successful reimplantation of his leg. However, The proximal tibial growth plate was severely damaged and his predicted leg length discrepancy at maturity was to be 15.5 cm. The first 2 lengthening surgeries were with an external fixator and the most recent at age 15 was done using the #precicenail to correct #leglengthdiscrepancy #hssllcrs #hsslimblengthening @hspecialsurgery @limblengtheningreconstruction #hsskids
