Pioneering Limb-Lengthening Technology Offers Painless Correction for Teen

July 25, 2016

SchillerThirteen-year-old Carlos Echevarria effortlessly moves his lanky body around using a pair of crutches. With no apparent cast or boot, you might guess he’s recovering from an ankle sprain or other minor sports injury.

You wouldn’t know it but Carlos is in the midst of a pioneering medical procedure. Inside his left leg is a titanium rod attached to his femur that – with the power of a tiny magnetic motor – gradually increases in length. The technology will make Carlos’ leg eight centimeters longer and correct a length discrepancy he has had since birth.

Performed recently by Jonathan Schiller, MD, a pediatric orthopedist at Hasbro Children’s Hospital, this new procedure eliminates the need for a large external frame fixed with wires and pins, often a cause of irritation and pain, and virtually always a source of infection.

Schiller is the first in Rhode Island to perform the procedure with the internal rod, called PRECICE Nail. He said that Carlos has been a model first patient, with outstanding results.

“The procedure and his progress has been as good as we could have hoped or expected,” said Schiller, two months after the surgery. “This new treatment option allows patients with a lower extremity limb length discrepancy to lengthen bone without a cumbersome external frame, less pain and no pin site infections.”

Hasbro Children’s Hospital is one of only few medical centers in New England using PRECICE Nail, which can also be performed on adults.

Schiller says the process takes some maturity and commitment from the patient, who must take a few minutes four times each day to activate the motor inside the rod using an external remote control, similar to a video game controller.

Each of the four sessions stretches the rod just .25 mm. The process is painless.

In Carlos’s case, the full course of treatment will take about 80 days. He’ll be off his crutches another three months after that. Once the bone has completely healed, the rod will be surgically removed approximately one year after it was placed.

The significant discrepancy in the length of Carlos’s legs was caused by an infection he suffered as a pre-term infant, which shut down a growth plate at the bottom of his thigh. Carlos was born at just 23 weeks, one of triplets. One of his brothers died shortly after birth, and the other died at age eight after living with cerebral palsy. Carlos now has two younger siblings, a 5-year-old brother and 2-year-old sister.

After all the family’s heartbreak, the opportunity to restore Carlos’s ability to walk and even eventually run pain-free is the answer to Carlos’s mother’s prayers.

“Seeing him walking with a lift in his shoe for so long, I was expecting a very difficult surgery with the big brace, and this has been amazing,” said his mother, Luz Valerio. “I am so thankful, and I see how happy he is when he measures his legs every day, numerous times each day. Now he’s busy looking online all the time for new shoes, finally with no lift.”

Christina Spaight O'Reilly

Senior Public Relations Officer
Rhode Island Hospital