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Limb lengthening with PRECICE magnetic nail in pediatric patients: A systematic review
Giulia Masci1, Osvaldo Palmacci1, Raffaele Vitiello2
1Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome 00168, Italy.
Insights
The PRECICE Nail System for pediatric limb lengthening shows promise but requires more research. Careful surgical planning is key to managing complex deformities and minimizing complications.
Area of Science:
- Pediatric Orthopedics
- Limb Lengthening Surgery
- Biomaterials and Medical Devices
Background:
- Limb lengthening is crucial in pediatric orthopedics.
- Implantable systems like PRECICE overcome external fixator limitations.
- PRECICE is a magnetically driven, remotely controlled intramedullary nail.
Purpose of the Study:
- Review current literature on PRECICE outcomes in pediatric limb lengthening.
- Assess clinical and radiological results.
- Identify potential complications.
Main Methods:
- Systematic review of five studies.
- Included 131 patients and 135 femurs.
- Analyzed lengthening, distraction rate, weight-bearing time, consolidation index, and ASAMI score.
Main Results:
- Data were comparable across studies, except for the consolidation index.
- Study population size and follow-up duration were insufficient for definitive conclusions.
Conclusions:
- PRECICE Nail System presents a therapeutic challenge in pediatric limb lengthening.
- Meticulous pre-operative planning and surgical technique are vital.
- Potential for correcting complex deformities with reduced complications.
Background:
Limb lengthening techniques play an increasingly important role in the pediatric orthopedic field. The principles of the osteogenesis distraction bonded traditionally with external fixators; however, the recent deployment of fully implantable systems has been able to overcome severities related to external fixators. The PRECICE® is an implantable limb lengthening intramedullary nail system that is remotely controlled and magnetically driven.
Aim:
To review the current literature available on this matter in order to assess the PRECICE clinical and radiological outcomes and its possible complications in a population of pediatric patients undergoing limb lengthening.
Methods:
Only five studies met the inclusion criteria and were consequently included in the review for a total of 131 patients and 135 femurs. The clinical and radiological outcomes of interest were: the main lengthening obtained, the distraction rate, the period of time to full weight bearing, the consolidation index, and the Association for the Study and Application of Methods of Ilizarov score.
Results:
In conclusion, data collected from the articles under investigation were comparable with the exception of the consolidation index. Unfortunately, the study population was too small and the patients' follow-up was too short to make definitive conclusions.
Conclusion:
This review shows that the PRECICE Nail System is still a therapeutic challenge in limb lengthening for pediatric orthopedic surgeons; however, careful pre-operative planning and an accurate surgical technique could allow the correction of more complex deformities with a low rate of complications.
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