Tibia Limb Lengthening (Precice 2)

Do you harbour dreams of a taller physical form? Thanks to modern medical science, augmenting one’s height via limb lenghtening techniques is now an achievable reality. This discourse aims to examine the Lower leg Lenghtening employing the Precice Nail technique – an avant-garde procedure delivering meticulous and manageable height restoration. Let’s delve deeper into this extraordinary technique and its transformative effects on many lives.

Height lenghtening is a surgical process designed to augment the length of the body, focusing on the femur (thigh bone) and the tibia (shin bone). It’s a popular choice among those wishing to alleviate height-related self-consciousness or individuals suffering from unequal limb length due to certain medical conditions.

The Precice Nail: At the heart of the Lower leg (Calf) Lenghtening procedure is the Precice Intramedullary Nail. This ground-breaking tool, designed by NuVasive Specialized Orthopedics, is engineered to provide accurate and gradual bone segment distraction, fostering controlled bone growth. The nail is placed into the bone’s intramedullary canal and comes with a remote control that allows patients to manage the lenghtening process.

A Glimpse into the Procedure

Preparation: The process starts with the surgical team preparing the patient for surgery. The patient is typically placed under general anesthesia to ensure they feel no pain during the operation.

Osteotomy: The orthopedic surgeon then makes a small incision at the site of the tibia. A specialized tool is used to cut the tibia bone, a process known as osteotomy. The aim here is to create two separate bone segments that can be gradually moved apart to allow for new bone formation.

Installation of the Device: Post osteotomy, an intramedullary nail, like the Precice nail, is carefully inserted into the tibia’s marrow canal. This nail is equipped with a remote-controlled mechanism that allows for controlled and gradual lengthening of the bone. Alternatively, an external fixator may be used, which is a frame that is attached to the bone segments with pins or wires.

Distraction Phase: After a few days to a week, known as the latency period, the distraction phase begins. Using the remote control (in the case of the intramedullary nail) or manual adjustments (in the case of an external fixator), the bone segments are slowly moved apart, typically at a rate of 1mm per day. This creates a gap where new bone tissue will form.

Bone Regeneration: Over time, new bone tissue forms in the gap created by the distraction process, a phenomenon known as distraction osteogenesis. The process can take several weeks or months depending on the desired amount of lengthening. During this time, regular X-rays are taken to monitor the formation of new bone.

Consolidation Phase: Once the desired length has been achieved, the distraction process is stopped to allow the newly formed bone to harden and strengthen, a phase known as consolidation. The bone must fully consolidate before the patient can bear full weight on the limb.

Removal of the Device: If an external fixator was used, it would be removed once the consolidation phase is complete. In the case of an intramedullary nail, the device may be left in place, unless it causes complications.

Rehabilitation: Physical therapy is an integral part of the process both during the lengthening and consolidation phases and after the removal of the device. Therapy helps to maintain joint mobility, muscle strength, and overall function of the limb while the bone is healing.

When it comes to tibia lengthening, several factors are specific to this bone and its anatomical and functional attributes. Here are some key aspects:

Anatomical Challenges: The tibia’s position just beneath the skin’s surface poses specific challenges, especially in terms of wound healing and potential risk of infection during lengthening procedures. Because the skin over the tibia is thin, there is less padding to protect against external pressure or rubbing from an external fixator device if one is used. Careful management is required to minimize these risks.

Muscle and Soft Tissue Contractures: The tibia’s role in major muscle attachments and movements can contribute to complications during lengthening. The limb’s muscles, nerves, and blood vessels must adapt to the lengthening bone, which can sometimes lead to tightness or contractures in the muscles and soft tissues surrounding the tibia. Regular physiotherapy and stretching exercises are often necessary to maintain flexibility and function during the lengthening process.

Mechanical Stability: The tibia bears a significant portion of body weight, so lengthening the tibia requires careful management to ensure mechanical stability during the bone regeneration phase. The new bone tissue formed during the distraction process is initially weak and may not adequately support full weight-bearing activities until it fully consolidates.

Nerve and Vessel Involvement: The proximity of important nerves and blood vessels to the tibia adds another layer of complexity to the lengthening process. There is a risk of damage to these structures during surgery, as well as potential complications like nerve compression or vascular compromise during the lengthening phase.

Compartment Syndrome Risk: The lower leg is divided into compartments that contain muscles, blood vessels, and nerves. When the tibia is lengthened, increased pressure within these compartments can potentially lead to a serious condition known as compartment syndrome, which requires immediate medical attention.

Healing Time: Tibia lengthening often takes longer and may be more complex than femur lengthening, largely due to the anatomical and functional factors mentioned above. The healing index (time required for every centimeter of lengthening) for the tibia is usually more compared to the femur.

It’s important to note that this is a complex procedure and the success greatly depends on the patient’s overall health, commitment to the physical therapy regimen, and careful follow-up with the surgeon. As with any surgical procedure, there are risks involved, including infection, nerve damage, or failure of the bone to lengthen or consolidate properly. Therefore, patients should have a thorough discussion with their healthcare provider to fully understand the benefits and risks of this procedure.

Recovery and Rehabilitation: After achieving the desired lenghtening, the nail remains intact to assist the healing process. Physical therapy and rehabilitation are vital to ensure successful recovery.

Perks of Lenghtening with Precice Nail.
Accurate and manageable lenghtening process.
Minimally invasive procedure with minute incisions.
Lessened risk of damage to nerves and blood vessels.
Diminished risk of infection in comparison to external fixation devices.
Enhanced patient comfort during the distraction phase.

Post-Procedure Care: Post-operative care is crucial for a successful result. Patients are advised to adhere to their surgeon’s directions, including wound care, pain management, and physical therapy. Regular follow-up appointments will be arranged to track progress and address any concerns.

Final Thoughts: Lenghtening with Precice Nail marks a significant leap for those desiring height enhancement or correction of limb length discrepancies. Its meticulous and manageable approach enables patients to achieve their height aspirations safely and efficiently.