title: Pitfalls in automatic limb lengthening - First results with an intramedullary lengthening device.
abstract: The treatment of leg length discrepancy and deformities has become more common over the last few decades due to newly developed implants. Lengthening using fully implantable intramedullary nails provides many advantages; however, only little data is available. Therefore, we aimed to determine: (1) safety of the implant, (2) the complication rate and (3) functional outcome after magnetic driven intramedullary bone lengthening with a telescopic implant.
  
  
  
  Automatic bone lengthening with intramedullary nails provide good short-term outcome.
  
  
  
  Ten patients with limb length discrepancy of lower extremity, treated with an Ellipse PRECICE®nail, were included in this retrospective follow-up study. The mean limb length discrepancy was 4.7cm (range: 2.5-7.0cm).
  
  
  
  In all patients, limb lengthening goals were reached within a range of ±0.5cm after a mean time of 53 days. However, in 2 patients, mechanical failures with unintended shortening were observed. In a further patient nail breakage occurred. Overall, 7 patients presented with complications during the follow-up period.
  
  
  
  The PRECICE®nail represents a new, fully implantable, magnetically driven device for limb lengthening. However, due to a high rate of complications, a close follow-up is necessary to identify early implant failures and to avoid severe adverse outcomes.
  
  
  
  Retrospective follow-up study, case series, level IV.
authors.affiliation: Medical University of Vienna, Department of Trauma Surgery, Medical University of Vienna, Waehringerguertel 18-20, 1090 Vienna, Austria.
authors.forename: T M
authors.initials: TM
authors.lastname: Tiefenboeck
authors.affiliation: Medical University of Vienna, Department of Trauma Surgery, Medical University of Vienna, Waehringerguertel 18-20, 1090 Vienna, Austria.
authors.forename: L
authors.initials: L
authors.lastname: Zak
authors.affiliation: Devision of General Anaesthesia and Intensive Care Medicine, Medical University of Vienna, Waehringerguertel 18-20, 1090 Vienna, Austria.
authors.forename: A
authors.initials: A
authors.lastname: Bukaty
authors.affiliation: Medical University of Vienna, Department of Trauma Surgery, Medical University of Vienna, Waehringerguertel 18-20, 1090 Vienna, Austria. Electronic address: gerald.wozasek@meduniwien.ac.at.
authors.forename: G E
authors.initials: GE
authors.lastname: Wozasek
mesh_terms: D000328:Adult; D000368:Aged; D001852:Bone Lengthening / Q000295:instrumentation* / Q000379:methods; D001858:Bone Nails; D002648:Child; D005260:Female; D005269:Femur / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007870:Leg Length Inequality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery*; D016896:Treatment Outcome
keywords: Complications; Intramedullary lengthening; Leg length discrepancy; Magnetically actuated; Preliminary results