Bone lengthening, also known as distraction osteogenesis, is an orthopedic surgical procedure aimed at increasing the length of a bone. This technique is often used to treat issues where normal bone growth has been disrupted due to a congenital malformation, injury, infection, or previous surgery. Bone lengthening is performed by an orthopedic specialist in bone deformities.
FIRST OPTION: External Fixation (e.g., Orthex Frame System by Ortho pediatrics)
The Orthex frame system involves using two metal rings fixed to the bone needing lengthening with special pins. These rings are connected by extendable supports, commonly known as “struts.” With these struts, the surgeon forms a hexapod, allowing adjustment of the bone’s orientation in three planes.
The bone lengthening process generally involves the following steps:
The surgeon makes an incision near the bone that needs lengthening.
Once the bone is exposed, the surgeon places an external fixation device, usually consisting of pins or screws, above and below the area to be lengthened.
Over time, usually several weeks, the patient or a healthcare professional makes slight daily rotations on the pins or screws of the external fixation device. This creates a gradual separation of the bone, stimulating the formation of new bone tissue between the two fragments. This step is essential for bone lengthening.
Once the bone has reached the desired length, it needs to remain in place for a while to allow the new bone to solidify and become strong.
Once the bone is sufficiently strong, the external fixation device is removed in another surgical procedure.
SECOND OPTION: Internal Fixation (e.g., PRECICE Nail by NuVasive)
The PRECICE nail is an advanced medical device designed to facilitate the bone lengthening procedure. It offers several advantages and improvements over traditional methods:
Unlike external fixation devices, the PRECICE nail is implanted directly inside the bone, eliminating the need for external hardware. This reduces the risk of infections, discomfort, and skin complications.
The PRECICE nail is remotely controlled, allowing necessary adjustments for bone lengthening without additional surgery. The patient or a healthcare professional can adjust the bone length using an external remote control, allowing more precise and easier adaptation throughout the lengthening process.
The PRECICE nail is equipped with sensors enabling doctors to monitor the lengthening progress in real-time to ensure everything is proceeding according to the treatment plan.
The absence of external hardware reduces the risk of skin irritation and discomfort for the patient. Additionally, the internal mechanism of the PRECICE nail can be more comfortable during the consolidation phase.
The PRECICE nail is available in various sizes and configurations to meet the specific needs of each patient, allowing optimal treatment customization.
Due to more precise adjustments and reduced complication risks, the PRECICE nail can reduce the overall time required for bone lengthening.
Summary
Bone lengthening can be a long and demanding process requiring close monitoring and rehabilitation. However, it can offer significant benefits for patients with bone length discrepancies, improving mobility and quality of life. It is important to note that this procedure carries potential risks and complications and is generally reserved for cases where the benefits outweigh the drawbacks. A qualified orthopedic surgeon is the best person to assess if bone lengthening is appropriate for a given patient.