Regenerate Deformity with the Precice Tibial Nail

Area of Science:

• Orthopaedic surgery
• Biomechanical engineering

Background:

• Distraction osteogenesis is a standard orthopaedic technique for limb lengthening.
• The Precice intramedullary lengthening system represents an advancement in this field.
• Limited data exists on the efficacy of the Precice system for tibial lengthening.

Purpose of the Study:

• To evaluate the early outcomes of tibial lengthening using the Precice intramedullary nail.
• To describe modifications to the surgical technique based on early clinical observations.

Main Methods:

• A prospective case series of 17 consecutive tibial lengthening procedures.
• Analysis of healing index, achieved length, range of motion, and complications.
• Comparison of initial cases with the recommended technique versus modified techniques.

Main Results:

• All 17 tibial lengthening procedures were completed successfully with the desired lengthening rate.
• No infections or issues with regenerate formation were reported.
• Progressive valgus and procurvatum deformities were mitigated in later cases by using Poller blocking screws.

Conclusions:

• The Precice tibial nail is effective for achieving bone length and satisfactory regenerate formation.
• The standard technique is insufficient to counteract deforming forces during tibial lengthening.
• An amended technique incorporating multiple blocking screws is recommended to prevent regenerate deformity.