Department of Pediatric Orthopaedics, Orthopaedic Hospital Vienna-Speising, Vienna, Austria.
J Pediatr Orthop. 2022 Feb 1;42(2):e192-e200. doi: 10.1097/BPO.0000000000002016.
The Precice intramedullary bone lengthening nail has been used in our department since 2013. We sought to determine the efficacy and safety of intramedullary limb lengthening with Precice nails in children and adolescents.
We retrospectively investigated patients 18 years and younger who underwent lower-limb lengthening using the Precice nail. Radiologic and clinical outcome data were obtained from a prospective database. The minimum postimplantation follow-up was 12 months. Between March 2013 and March 2020, 161 patients underwent limb lengthening with a Precice nail; 76 patients met the inclusion criteria.
We used 84 nails in 76 patients (68 femurs and 16 tibias). Femoral nails were inserted using an antegrade approach in 57 patients and a retrograde approach in 11. The mean age at surgery was 16 years (range, 9 to 18 y). The mean lengthening was 33 mm (range, 14 to 80 mm) with additional acute axial or rotational malalignment correction in 16 segments. At the last follow-up (mean=2.1, years; range, 1 to 5 y), all regenerates had healed and all patients were mobile with full weight-bearing. Complications that necessitated surgical revision occurred in 6 patients (8%), and the desired lengthening was not achieved in 2 patients. Postlengthening malalignment occurred in 4 patients (5 tibial nails). The weight-bearing index, defined as days from surgery to full weight-bearing/cm of lengthening, was a mean of 45 days (range, 7 to 127 d/cm).
The Precice nail facilitated reliable and safe bone lengthening and was associated with a low complication rate. Correction of additional malalignment was possible by applying intraoperative acute correction or guided growth.
Level IV-therapeutic study investigating the results of treatment.
Precice 髓内骨延长钉自 2013 年以来已在我院使用。我们旨在确定 Precice 钉在儿童和青少年中进行髓内肢体延长的疗效和安全性。
我们回顾性调查了使用 Precice 钉进行下肢延长的 18 岁以下患者。影像学和临床结果数据来自前瞻性数据库。植入后最低随访时间为 12 个月。2013 年 3 月至 2020 年 3 月，161 例患者采用 Precice 钉进行肢体延长，其中 76 例符合纳入标准。
我们在 76 例患者（68 例股骨和 16 例胫骨）中使用了 84 枚钉子。57 例患者采用顺行入路插入股骨钉，11 例患者采用逆行入路插入。手术时的平均年龄为 16 岁（范围：9 至 18 岁）。平均延长 33 毫米（范围：14 至 80 毫米），16 个节段同时进行急性轴向或旋转对线不良矫正。末次随访时（平均 2.1 年；范围：1 至 5 年），所有再生骨均已愈合，所有患者均可负重活动。6 例（8%）患者需要手术修正并发症，2 例患者未达到预期延长。4 例（4 例胫骨钉）发生延长后对线不良。负重指数定义为从手术到完全负重/延长长度的天数，平均为 45 天（范围：7 至 127 天/cm）。
Precice 钉可实现可靠、安全的骨延长，并发症发生率低。通过应用术中急性矫正或引导生长，可矫正额外的对线不良。
IV 级——治疗研究，调查治疗结果。
