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
Processing time: 194 Days and 3.4 Hours
ARTICLE HIGHLIGHTS
Research background

Limb lengthening devices have evolved in the last century to correct limb length discrepancies, congenital short statures, and limb deformities. The unilateral external fixator has been the standard method of fixation for a long time; however, the method of fixation has rapidly evolved from unilateral external fixator to the ring fixator, to the computer-assisted fixator, and finally to the lengthening of intramedullary nails.

Research motivation

The large number of complications related to the use of external fixation has led to the development of alternatives. The PRECICE represents an innovative and less invasive option to external fixation with regard to limb lengthening, allowing a controlled lengthening phase with the ability to shorten and regulate the device if necessary.

Research objectives

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

Research methods

The current study is the result of a systematic review of the available literature using a single search term “PRECICE”. The articles were sorted according to both predetermined inclusion and exclusion criteria. PRISMA was followed.

Research results

Five studies met the inclusion criteria for a total of 131 patients. The studies examined focused on the following issues: the main lengthening obtained, the distraction rate, the number of days necessary to reach full weight bearing, the consolidation index and the ASAMI score. Among the articles all the results were almost comparable with the only exception of the consolidation index. Adverse events that emerged in a low percentage were divided into problems, obstacles, and complications.

Research conclusions

Although the PRECICE nail system is still a therapeutic challenge, the results have shown excellent clinical results and patient satisfaction with a low rate of complications. Therefore this approach could represent a valid alternative to the traditional limb lengthening systems.

Research perspectives

Future studies on larger and more homogeneous samples are needed to validate the use of PRECICE.