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Abstract
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Introduction – Distraction osteogenesis is an appreciated technique to correct limb shortening of various etiologies. An external fixator is commonly used to ensure 3D dimensional correction and lengthening. However, intramedullary devices have been showing similarly good results over the last decade providing a more comfortable distraction procedure with reduced risk of infection at the same time.
Purpose – To present the first case of humeral lengthening and operative technique using a magnet-operated intramedullary nail in Switzerland.
Methods – A 13-year-old girl with humeral shortening of 5 cm resulting from traumatic upper plexus palsy of the right arm during birth was treated with humeral osteotomy and implantation of a motorized intramedullary nail (PRECICE® magnet-operated Internal Bone Lengthening Nail, Ellipse Technologies, Inc, Irvine, CA, USA) for gradual lengthening. Individualized lengthening was performed using varying distraction rate in support of nervous tissue.
Results – The humeral lengthening of 5 cm was successfully achieved without complications 78 days after the beginning of distraction. The range of motion for the elbow and shoulder did not decrease during the lengthening or the current follow-ups. Implant removal will be performed after consolidation. Distraction and consolidation rate was analyzed.
Conclusion – This is the first case of an intramedullary motorized femoral nail which was used for humeral lengthening in Switzerland. No intra- or postoperative complications occurred and the patient could perform lengthening in an out-patient clinical setting. Intramedullary lengthening of the humerus with a motorized nail might be an appropriate alternative to external fixators.
Level of evidence: IV
Key words – humerus, lengthening, intramedullary, motorized nail, pediatric, Precice
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