A new era in limb lengthening.
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I’m an Orthopedic Surgeon
I have a strong commitment to offer my patients the latest techniques in lengthening surgery and deformity correction.
Since 2004, I have been dedicated to the correction of bone deformities. One of my specialties is to correct limb length discrepancies, stretching out shortened bones.
The PRECICE 2 is the most sophisticated elongation device available today, with excellent elongation control that extends in a manner similar to that of an antenna. In addition, it is the only device on the market that has a reverse mechanism, a very important safety feature that allows the elongation to be reversed if necessary. During the lengthening process, patients conveniently use an external remote control to rotate a magnet located inside the nail. This, in turn, turns gears that rotate a drive screw, which extends the telescoping nail. These processes cause minimal pain to the patient.
The PRECICE 2 can extend up to 8 cm in length and its strength is up to 4 times stronger than PRECICE 1 (allowing more weight to be carried). In addition, the connection strength of the drive shaft has been increased 3 times more than in PRECICE 1, reducing the risk of failure of the nail mechanism when the patient makes too much bone, a complication that can cause premature consolidation of bone tissue that stops the lengthening process.
In summary, the PRECICE 2 allows for a higher lengthening rate, is stronger, has a stronger drive shaft and features a wider diameter range to accommodate patients of all sizes.
The PRECICE 2 allows up to 8 cm of lengthening, so patients who wish to achieve more length should consider a second lengthening of the other leg bone (tibia).
The highest amount of pain is immediately after surgery. Due to this, all of our patients are given epidural anesthesia or PCA (patient-controlled analgesia) to control postoperative pain. When they are discharged, they are provided with oral pain-killers. During the first two weeks after surgery, most patients still feel some pain. The most painful moments are during physical therapy exercises and going to bed, so oftenly some sleep medication must be taken. Except at those moments, most patients do not complain of much pain during the day. The actual lengthening process with PRECICE is generally painless and most patients have little or no pain during most of the lengthening process.
If the patient chooses to undergo a second lengthening, an interval of six to twelve months is recommended. However, it is possible to overlap femur and tibia lengthening.
During distraction, the ends of the bone are held apart by the nail itself. This nail is fixed to the bone with screws at each end. With enough repeated loading, the screws of any implant can bend or break. No implant is immune to this and the heavier the patient, the greater this risk. The patient is allowed full weight-bearing when a bone bridge is seen on the radiograph. At that point, the bone takes the load and protects the nail. During lengthening we allow the use of crutches or a walker, which allows the weight of the legs to be transferred to the arms.
The amount of weight-bearing depends on the patient's weight, the bone or bones being lengthened and the size of the nail. Walking with a single crutch during the distraction phase is not permitted, regardless of the patient's weight. During the consolidation phase, weight bearing will be allowed depending on the quality of the bone callus growth.
Placing the PRECICE device is a minimally invasive method where a 3 centimeter incision is made in the hip area and another 4 or 5 incisions of less than 1 centimeter on the side of the thigh.
These scars are so small that they are almost imperceptible (most are no bigger than a mosquito bite).
It will depend on the radiographic follow-up. This generally occurs after one to three months after the end of the distraction phase.
As a reference: an 8 cm lengthening requires three months to complete the lengthening in the femur and another two to three months for the bone to heal enough to allow full weight bearing without crutches; a total of 5-8 months corregir en la otra web.
A 5 cm femoral lengthening takes almost two months to complete lengthening and another month or two to allow full weight bearing without crutches.
For the tibia, a 5 cm lengthening requires three months to complete lengthening and another two to three months until the bone heals enough to allow full weight bearing without crutches.
Undergoing bone lengthening surgery is not to be taken lightly. You have always wanted to increase your height but, many doubts and concerns arise. The main one is: When can I go back to my normal life? To work? To practice sports? Except for being shorter than you would like to be, you are an otherwise healthy person and our goal is to get you back to your pre-surgical status. After surgery, you will be using a wheelchair and crutches to get around.
As a reference, an 8 centimeter lengthening takes about 3 months to complete and another 2-3 months for the bone to be strong enough to support your body weight. In total, about 6-8 months. Allowing weight bearing depends on several factors: your body weight, the type and diameter of nail implanted and the amount of lengthening performed. If you do not follow our instructions, you may bend the nail, fracture the bone and have to return to the operating room. Typically, you will begin to bear more weight one month after the lengthening is completed. Although it is not recommended, you can drive if you can transfer from the car seat to the wheelchair. Under no circumstances do we authorize riding in two-wheeled vehicles.
You must regain mobility and, subsequently, muscle strength before returning to sports. If you are persistent and work hard in physical therapy, you can resume your sports activities six months after surgery.
Obviously, the physician will individually set the appropriate pace for each patient. Generally, most patients can begin running a couple of months after they are off crutches and can return to higher intensity contact sports, such as soccer or basketball, one month after they begin running.
The cost-estimate is approximate and just a guideline, since the patient has not been evaluated in the clinic and does not include unforeseen events that may arise during the operation that require the use of any other material or treatment, as well as complications of the same or subsequent interventions.
The patient will receive constant attention from a physiotherapist, until the subsequent removal of the pins.