Minor leg length discrepancies are common — 23 percent of the general population has a discrepancy of at least 1 centimeter. The prevalence of leg length discrepancies requiring correction is about 1 in 1,000, whereas the most severe problems, such as congenital femoral deficiency, are quite rare. Limb lengthening has long been an accepted treatment for both common and complicated discrepancies and deformities, although the indications have broadened considerably over the last 100 years.
Originally used to correct discrepancies resulting from poliomyelitis, war injuries, and fracture malunion or nonunion, limb lengthening is now used for a wide range of congenital, metabolic, oncologic and post-traumatic orthopedic problems. It is also an accepted treatment for short stature — a common feature of some musculoskeletal syndromes.
Limb-lengthening devices
Arguably the greatest recent advance in limb lengthening was the 2011 Food and Drug Administration approval of Precice, an implantable intramedullary rod (nail). The rod, which is indicated for limb length discrepancy and short stature, is surgically implanted in the intramedullary canal of the tibia or femur. It has a magnetic metal spindle connected to a series of gears.
The gears, in turn, are connected to a coupling and threaded drive shaft that is activated by an external, remote-controlled device operated by the patient. The remote control contains two magnets that rotate the spindle. Depending on the direction, the distracting rod either lengthens or shortens at a maximal rate of 1 millimeter a day, thus achieving 50 millimeters of lengthening in about 50 days. The shortening function can be used for soft tissue problems or to stimulate additional bone formation.
Accurate rate control is one of the major advantages of the new device. Earlier implantable rods were plagued by imprecise distraction, leading to nerve injuries, joint contractures and nonunions.
The mean total lengthening was 35 millimeters, with an accuracy of 96 percent and precision of 86 percent. All patients achieved the intended distraction goal without a change in bone alignment or knee and ankle range of motion. One patient experienced implant failure caused by a nonfunctioning distraction mechanism; six others had nonimplant-related complications, including delayed bone healing.The complication rate is less than 5 percent.
The device is usually removed 12 to 24 months after implantation, when the bone has fully healed on all four cortices.
External fixation
Some patients needing limb lengthening who have previous implants, associated deformities, active infection or other confounding factors may need treatment with an external fixator rather than an internal system. The fixator, which consists of two or more rings connected to six telescopic struts that can be lengthened or shortened, allows gradual lengthening and deformity correction by adjusting strut lengths according to a computer-generated treatment plan.
About PUSM
Shenyang Pusman Medical Equipment Co., Ltd. was established in 2006. It is a professional enterprise integrating R & D, manufacturing and sales. It specializes in producing medical equipment according to national standards. Our company's main products: medical electric saw drill series; imported brushless motor series; domestic high-quality brushless motor series; medical electric drill pendulum saw integrated multi-functional system; hand, foot and ankle special system; pedicle screw screwing into special power; external Fixed needles are screwed into special power; external fixation series; bone cement; bone cement guns and other orthopedic surgical instruments.
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