Leg Lengthening with intramedullary (internal) nail Precice I/II or ISKD
The nail is inserted in the leg (femur or tibia) and after the osteotomy (cut of the bone) it is fixed proximally and distally with screws. To start the lengthening the Precise uses a magnetic mechanism while the ISKD is operated with a mechanical mechanism triggered by rotational movements of the segment lengthened (clicks).
This method is quite comfortable for the patients. There are no external devices. Muscular contractures are still possible as for all other techniques. The operation is longer, there is a considerable blood loss and carries the risk of fat embolism. In case of delated consolidation using ISKD the only option is to have another procedure consisting in bone graft.
At the end of the treatment, when a solid consolidation of the new bone is achieved the nail is removed.
Lengthening the tibia with a nail is often associated with permanent anterior knee pain.
This method is more expensive (2 or 3 times the cost of an external fixture) due to the high cost of the nails.
Possible risks of this procedure:
- Wound and bone infection
- Delayed bone consolidation needing a second procedure such as bone grafting
- Deformities needing further surgery
- Metalwork fatigue and break
- Fracture during the surgery. This complication have never been experienced by our patients but are described in the literature. This will need to stop the lengthening and deal with the fracture.
- Muscles contractures
- Neurovascular problems due to blood vassels or nerve stretching. This complication have never been experienced by our patients but are described in the literature.