Limb Lengthening

Intramedullary Nail

What is intramedullary nail?

The PRECICE^® intramedullary nail was approved by the FDA in 2011 for clinical use in limb lengthening. In contrast to external fixators, the metal device that supports and lengthens the bone is entirely internal. Intramedullary lengthening nails eliminate certain disadvantages of external fixators including discomfort or dislike of the frame and pin site infections. Be sure to ask your doctor about the risks and complications that may occur with limb lengthening.

How does the PRECICE nail work?

An external magnet is applied to the skin three to four times a day for about two minutes. The external revolving magnet interacts with an internal magnet within the nail that expands the device. The bone is lengthened with the nail at an average rate of 1mm/day. The body heals and makes new bone to fill the gap. The process may take months.

The bone may be slower to heal after lengthening with a nail. The doctor may alter the rate at which the bone lengthens to stimulate better healing.

What should we expect during my child's hospital stay?

Will the PRECICE nail hurt?

What should we expect during my child's follow up doctor visits?

Will my child need physical therapy?

Physical therapy is an important part of recovery to minimize (decrease) complications associated with joint stiffness. After discharge from the hospital, focus on walking each day. Your child may require sessions with your therapist one to two times per week, especially during the lengthening period when the bone and muscles stretch. The therapist will instruct your child how to perform daily exercises to increase strength and improve joint range of motion. The nail is NOT stable enough to support the bone for full weight bearing.

You must use crutches or a walker at all times when walking until the bone is healed. This may be several months. Follow the instructions of your doctor and therapist to avoid potential problems of the nail or bone breaking.