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Humerus Lengthening With the PRECICE Internal Lengthening Nail
Anton M Kurtz1, S Robert Rozbruch
1*MaineOrtho, Portland, ME †The Limb Lengthening and Complex Reconstruction Service, Department of Orthopedic Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY.
Journal of Pediatric Orthopedics
|March 1, 2017
Summary
This study reports the first use of a motorized intramedullary nail for humeral lengthening in a pediatric patient with significant arm shortening. The technique successfully corrected limb length discrepancy while preserving shoulder and elbow function.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Limb reconstruction
Background:
- Proximal humerus growth disturbance can cause substantial upper limb-length discrepancy in children.
- Previous limb lengthening utilized external fixation devices.
- Intramedullary implants had not been reported for humeral lengthening.
Observation:
- A 15-year-old female with post-treatment unicameral bone cyst humeral shortening underwent osteoplasty and lengthening.
- A fully implantable motorized intramedullary nail was used off-label for gradual humeral lengthening.
- A varus deformity and lateral entry point facilitated the procedure, avoiding rotator cuff injury.
Findings:
- Achieved 5 cm of humeral lengthening in 9 weeks.
- Bony union occurred at 7 months, with hardware removal at 9.5 months.
- Maintained shoulder and elbow range of motion throughout treatment and post-operatively.
Implications:
- Demonstrates the feasibility of using motorized intramedullary nails for pediatric humeral lengthening.
- Offers a potential alternative to external fixation for correcting limb-length discrepancies.
- Highlights the need for further investigation into technical limitations and long-term outcomes.
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