Since 2011, we have been using internal bone lengthening. This has been the most significant advance in our field in the last decade. With the use of an internal lengthening nail, we can avoid the use of external fixation entirely. With bone lengthening, we perform an osteotomy (bone cut) and gradually pull the bone apart very slowly with a regular rate and rhythm. Since bone has the ability to regenerate, new bone gradually grows in the space leading to bone elongation. In the past, we could use only external fixation to gradually lengthen the bone, but now the internal lengthening nail has replaced external fixation for most long bone lengthening surgeries. A telescopic rod in inserted into the marrow cavity of the bone. A remote control device spins a magnet in the rod which turns a gear and elongates the rod which lengthens the bone. The internal method is very accurate and is safer and more comfortable for the patient compared to external fixation.
Reach Your Height PodcastThe Reach Your Height podcast brings expert surgeons together to discuss limb reconstruction and lengthening treatments for patients of all ages. Listeners will gain intimate knowledge of current concepts and technologies, lessons learned, and what the future brings.
Patient Information Packets
Eugene Devlin
"For the first time in my life I have both legs the same length, I no longer wear a lift and I don’t walk with a limp. I feel great, I was back playing golf seven months after surgery and I resumed skiing this January without a specially fitted ski boot."
- Treatment of Angular Deformity and Limb Length Discrepancy With a Retrograde Femur Magnetic Intramedullary Nail: A Fixator-assisted, Blocking Screw Technique
Geiger, Erik J. MD; Geffner, Adam D. BS; Rozbruch, S. Robert MD; Fragomen, Austin T. MD
JAAOS: Global Research and Reviews, May 2023.- Cost Comparison of Femoral Distraction Osteogenesis With External Lengthening Over a Nail Versus Internal Magnetic Lengthening Nail.
Richardson SS, Schairer WW, Fragomen AT, Rozbruch SR.
J Am Acad Orthop Surg. 2019 May- Assessment of Bone Healing During Antegrade Intramedullary Rod Femur Lengthening Using Radiographic Pixel Density.
Ettore Vulcano, MD; Jonathan S. Markowitz, BS; Shabaz Ali; Joseph Nguyen, MPH; Austin T. Fragomen, MD; S. Robert Rozbruch, MD.
J Am Acad Orthop Surg 2018.- Simultaneous Acute Femoral Deformity Correction and Gradual Limb Lengthening Using a Retrograde Femoral Nail: Technique and Clinical Results.
Christopher A. Iobst; S. Robert Rozbruch; Scott Nelson; Austin Fragomen.
J Am Acad Orthop Surg 2018.- A Comparison of Femoral Lengthening Methods Favors the Magnetic Internal Lengthening Nail When Compared with Lengthening Over a Nail. Austin T. Fragomen, MD, Anton M. Kurtz, MD, Jonathan R. Barclay, BS, Joseph Nguyen, MPH, S. Robert Rozbruch, MD.
HSS Jrnl (2018).- Lengthening and deformity correction about the knee using a magnetic internal lengthening nail. Austin T. Fragomen and S. Robert Rozbruch.
SICOT J 2017- Transitioning to an Intramedullary Lengthening and Compression Nail.
Fragomen AT.
J Orthop Trauma, June 2017.- Adult Posttraumatic Reconstruction Using a Magnetic Internal Lengthening Nail.
S. Robert Rozbruch, MD.
J Orthop Trauma, June 2017.- Humerus Lengthening With the PRECICE Internal Lengthening Nail.
Anton M. Kurtz, MD and S. Robert Rozbruch, MD.
J Pediatr Orthop, June 2017.- Lengthening of the Femur with a Remote-Controlled Magnetic Intramedullary Nail: Retrograde Technique.
Austin T. Fragomen, MD, S. Robert Rozbruch, MD,
JB&JS Essential Surgical Techniques, May 11, 2016- Lengthening of the Femur with a Remote-Controlled Magnetic Intramedullary Nail: Antegrade Technique,
S. Robert Rozbruch, Austin T. Fragomen,
JB&JS Essential Surgical Techniques, January 13, 2016.- Motorized Intramedullary Nail for Management of Limb-length Discrepancy and Deformity
- Precision of the PRECICE Internal Bone Lengthening Nail
Videos
S. Robert Rozbruch, MD
S. Robert Rozbruch, MD
S. Robert Rozbruch, MD
S. Robert Rozbruch, MD
S. Robert Rozbruch, MD
Austin T. Fragomen, MD
Articles
Orthopedic Trauma Association Meeting
Drs. Rozbruch, Fragomen, and Bernstein (former fellow) did an educational session on Precice internal lengthening at this meeting in San Diego, CA on October 8, 2015Precice Lengthening Nail
Retrograde Technique
Tibia Technique
Implant Logistics