Two consecutive limb lengthenings with the same PRECICE nail: a technical note.
PURPOSE
The most significant advance in our time about limb lengthening is the magnetic lengthening nail, as the first reports appeared to show good results with accurate lengthening rates and good regenerate bone formation. The described complication rate is generally low. They avoid external fixation elements, and are activated transcutaneously, so the patient's pain and discomfort are reduced and the rehabilitation is faster and more effective. The aim of authors is to describe a special technical issue of the PRECICE system: the nail can be extended inside the patient limb (after the osteotomy), but it also can be retracted inside the limb after achieving the bone union.


METHODS
The authors present a case in which the limb lengthening has been performed in consecutive lengthening periods using the same nail. The nail was extended and retracted by altering the settings on the external remote control as well as accurately setting the rate of distraction.


RESULTS
After two consecutive femoral lengthening with the same PRECICE nail, the patient no longer has a significant lower limb length discrepancy and patient satisfaction was high. During this clinical case, we were not confronted with any type of complications.


CONCLUSION
This technique utilizes the principles and advantages of lengthening over an magnetic lengthening nail, avoids the necessity of nail removal and minimizes the complication rates and the overall time for complete recovery.


LEVEL OF EVIDENCE
Level IV.
['Couto|André|A|http://orcid.org/0000-0002-7981-8125', 'Freitas|Joana|J|', 'Alegrete|Nuno|N|', 'Coutinho|Jorge|J|', 'Costa|Gilberto|G|']
Limb Lengthening Nail Magnetic Deformity