Limb ReconstructionClinical results and complication rates of lower limb lengthening in paediatric patients using the PRECICE 2 intramedullary magnetic nail: a multicentre studyNasto, Luigi Aurelioa; Coppa, Valentinoa; Riganti, Simonea; Ruzzini, Laurab; Manfrini, Marcoc; Campanacci, Laurac; Palmacci, Osvaldob; Boero, SilvioaAuthor Information aDepartment of Paediatric Orthopaedics, IRCCS Istituto Giannina Gaslini, Genoa bDepartment of Paediatric Orthopaedics, Ospedale Pediatrico Bambino Gesù, Fiumicino, Rome c3rd Unit of Orthopaedics and Traumatology, Istituto Ortopedico Rizzoli, Bologna, Italy Correspondence to Luigi Aurelio Nasto, MD PhD, U.O.C. Ortopedia e Traumatologia, IRCCS Istituto “Giannina Gaslini”, Via Girolamo Gaslini 5, 16147 Genova, Italy, Tel: +39 010 5636 2395; fax: +39 010 382085; e-mail: firstname.lastname@example.org Journal of Pediatric Orthopaedics B: November 2020 - Volume 29 - Issue 6 - p 611-617 doi: 10.1097/BPB.0000000000000651 Buy Metrics Abstract Implantable intramedullary nail lengthening devices (e.g., PRECICE 2 system) have been proposed as alternative method to external fixation for lower limb lengthening surgery. The aim of this study was to analyse our outcomes and complications using the PRECICE 2 (P2) nail system and review them in light of the existing literature. A retrospective multicentre study was conducted on patients <18 years, who were treated for limb lengthening using the P2 system. The inclusion criteria were a limb length discrepancy ≥ 30 mm and a follow-up ≥6 months after the end of treatment. A total of 26 (15 males) patients were included, average age was 14.7 ± 2.3 years; 26 nails (21 femur, 5 tibia) were implanted. The average goal lengthening was 49.4 ± 12.4 mm, while average achieved lengthening was 44.4 ± 11.6 mm. Average distraction and consolidation indexes were 11.9 ± 2.1 days/cm and 25.1 ± 8.1 days/cm, respectively. Nail accuracy and reliability were 91.1% and 88.5%, respectively. A total of five problems (joint contractures), one obstacle (femur fracture) and three complications (hip joint subluxation, deep infection and nail running back) were encountered. The P2 nail system is a valid alternative to external fixator for limb lengthening in young patients with no significant angular or rotation deformities. Our study confirms a favourable complication rate and available evidence from literature suggests a lower complication rate than external fixator systems. Nevertheless, surgeons should keep a watchful eye on risk of joint subluxation and mechanical complications with intramedullary lengthening. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.