Results of Lower Limb Bone Lengthening by Using Motorized and Magnet-Driven Intramedullary Nails to Treat Limb Length Discrepancy.

INTRODUCTION

Limb length discrepancies (LLDs) can be treated with limb lengthening using external fixation or intramedullary nails, such as PRECICE or FITBONE. PRECICE is a magnetically driven titanium nail, while FITBONE is a motorized nail; both use an external remote control. This study aimed to determine the complications, compensation of length difference, time needed for compensation, and healing outcome of bone lengthening using motorized or magnet-driven intramedullary nails among non-cosmetic limb lengthening cases.

METHODS

This retrospective study was derived from a single surgeon's practice at a tertiary hospital in Jeddah, Saudi Arabia. Between 2009 and 2020, 15 patients with LLDs, with a mean age of 25.43 years (range 16-35 years), were identified. The study included congenital, post-traumatic, idiopathic, and acquired causes of LLDs. Outcomes were measured using complete lengthening and healing indices, which need the presence of three intact cortices out of four.

RESULTS

All patients achieved correction of their limb length without any device failure or nail breakage. The achieved limb length for all patients averaged 38.4 mm, ranging from 21 to 60 mm. No intraoperative complications were observed. Postoperatively, one patient reported knee stiffness, and another developed deep venous thrombosis. Duration of distraction (average 43.93 days, range 30-66 days) and the mean healing index was 32 days/cm for both the femur and tibia.

CONCLUSION

This study confirms that intramedullary nail PRECICE 2 and FITBONE systems are reliable and effective lengthening devices for treating lower LLDs and deformities. These devices significantly reduce complications and achieve excellent outcomes.