Bone Abstracts (2015) 4 IS11 | DOI: 10.1530/boneabs.4.IS11

Recent advances in limb lengthening and deformity correction

John Herzenberg

Baltimore, Maryland, USA.

External fixation has been the gold standard for patients who require bone lengthening. This method is accurate and reliable, but can result in significant scarring, superficial infection, and pain. Additionally, the daily care of pin sites, unsightly appearance of the device, and reduced function can be emotionally taxing for both the patient and caregivers. An internal device that lengthens through rotational movement was developed to address some of these issues (ISKD). Although cosmetically superior, the device was sometimes uncontrolled, which could lead to soft tissue contractures, healing problems, nerve injury, and excessive pain. In late 2011 a new, controllable internal device called the PRECICE (Ellipse Technologies, Irvine, CA, USA) was approved for use in the USA. We have used this device successfully in over 150 patients, aged 7–66. We conducted a study in which we administered a 13-question survey to patients who had experienced treatment with both external fixation and the PRECICE. Patients reported higher satisfaction rates with the PRECICE in regard to ease of physical therapy, cosmetic results, complications, day to day function, return to physical and social activity, and overall satisfaction. All patients stated that if they required surgery again, they would choose the PRECICE device. From a patient/parent perspective, this internal lengthening device rates far superior to external fixation. Participants felt that it resulted in less pain, fewer complications, and allowed for a quicker return to daily living. Although not everyone is a candidate for the PRECICE, it offers a promising alternative to previously available options.

Disclosure: Receipt of grants/research support: Ellipse Technologies; Receipt of honoraria/consultation fees: Orthopediatrics.

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