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Intramedullary Nail

What is it?

The PRECICE® 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 it work?

An external magnet is applied to the skin 3-4 times a day for about 2 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.

Hospital stay

Your child will rest the evening after the surgery. The day after surgery the physical therapist will teach your child how to walk with crutches or a walker. Most patients leave the hospital in one or two days. 

Will it hurt?

After the surgery, your child will be given medicine to help with the pain. Prescription pain medicine will be provided when you leave the hospital to take home. In general, the application of the magnet and gradual process of the bones moving does not hurt. 

Doctor visits

Five to seven days after surgery, the doctor will teach you how to begin lengthening the bone. You will return to the doctor 1-2 times a week or one time every two weeks during the lengthening process. During the healing process, clinic visits may occur monthly. 

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 1-2 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.

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