Systematic Reviews
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Aug 18, 2021; 12(8): 575-583
Published online Aug 18, 2021. doi: 10.5312/wjo.v12.i8.575
Limb lengthening with PRECICE magnetic nail in pediatric patients: A systematic review
Giulia Masci, Osvaldo Palmacci, Raffaele Vitiello, Nadia Bonfiglio, Maria Beatrice Bocchi, Valerio Cipolloni, Giulio Maccauro, Enrico Pola
Giulia Masci, Osvaldo Palmacci, Raffaele Vitiello, Nadia Bonfiglio, Maria Beatrice Bocchi, Valerio Cipolloni, Giulio Maccauro, Enrico Pola, Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome 00168, Italy
Enrico Pola, Policlinico di Napoli University Hospital, Università della Campania Luigi Vanvitelli School of Medicine, Napoli 80100, Italy
Author contributions: Palmacci O and Masci G designed the study; Cipolloni V and Vitiello R contributed to the data collection and data analyses; Masci G and Bonfiglio N contributed to the manuscript preparation; Bocchi MB and Pola E contributed to revising the manuscript content.
Conflict-of-interest statement: The authors declare that there are no conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Raffaele Vitiello, MD, Doctor, Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy. lele.vitiello@gmail.com
Received: January 29, 2021
Peer-review started: January 29, 2021
First decision: May 3, 2021
Revised: May 12, 2021
Accepted: June 22, 2021
Article in press: June 22, 2021
Published online: August 18, 2021
Abstract
BACKGROUND

Limb lengthening techniques play an increasingly important role in the pediatric orthopedic field. The principles of the osteogenesis distraction bonded traditionally with external fixators; however, the recent deployment of fully implantable systems has been able to overcome severities related to external fixators. The PRECICE® is an implantable limb lengthening intramedullary nail system that is remotely controlled and magnetically driven.

AIM

To review the current literature available on this matter in order to assess the PRECICE clinical and radiological outcomes and its possible complications in a population of pediatric patients undergoing limb lengthening.

METHODS

Only five studies met the inclusion criteria and were consequently included in the review for a total of 131 patients and 135 femurs. The clinical and radiological outcomes of interest were: the main lengthening obtained, the distraction rate, the period of time to full weight bearing, the consolidation index, and the Association for the Study and Application of Methods of Ilizarov score.

RESULTS

In conclusion, data collected from the articles under investigation were comparable with the exception of the consolidation index. Unfortunately, the study population was too small and the patients’ follow-up was too short to make definitive conclusions.

CONCLUSION

This review shows that the PRECICE Nail System is still a therapeutic challenge in limb lengthening for pediatric orthopedic surgeons; however, careful pre-operative planning and an accurate surgical technique could allow the correction of more complex deformities with a low rate of complications.

Keywords: Limbs lengthening, PRECICE, Nail, Pediatric, Dysmetria, Deformities

Core Tip: Limb lengthening techniques play an increasingly important role in the pediatric orthopedic field. The PRECICE® is an implantable limb lengthening intramedullary nail system that is remotely controlled and magnetically driven. The aim of our study was to review the current literature in order to assess the clinical and radiological outcomes and possible complications in a population of pediatric patients undergoing limb lengthening. This review shows that the PRECICE allows correction of the more complex deformities with a low rate of complications.