Magnetic Intramedullary Nail (MIN) Method

This method is accomplished by placing a telescopic nail inside the bone. It is a less invasive method compared to the combined method. It has been safely used for the last 10 years. This offers advantages such as minimal infection risk, minimal scarring, no need for casting, and therefore easier showering. However, it has disadvantages like being expensive, requiring an external lengthening device (ERC), and weight restrictions.

Evaluation

After the patient is examined by the doctor and no physical or psychological obstacles are observed, the next step is taken. A high-quality and properly calibrated leg length X-ray is taken. Then, the doctor evaluates whether the bone structure is suitable for surgery by making all measurements on the X-ray. Based on the measurements taken, a decision is made on which bone to choose for lengthening, and the patient is prepared for preoperative tests and consultations.

After the tests and consultations are completed without any issues, the patient is asked to fast for 8 hours before the scheduled surgery time.

Surgery

Placement of the intramedullary nail Removal of the intramedullary nail (evaluated according to the consolidation process)

Before entering the surgery, a final evaluation is performed, X-ray assessments are reviewed, informed consent forms and necessary documents are checked, and the type of anesthesia the patient will receive is determined in consultation between the anesthesia doctor and the patient.

After ensuring a suitable operating environment and draping, the surgical steps are carried out:

• Necessary measurements and markings are made.
• Preparation of the osteotomy line.
• Determination of the entry point for the nail.
• Reaming of the bone.
• Completion of the osteotomy.
• Placement of the intramedullary nail and locking with proximal and distal screws.
• Placement of the ankle screw.
• Fibula osteotomy.
• Intraoperative monitoring of lengthening under fluoroscopy.

The same procedures are applied in the same order for the other side and completed.

Early Follow-up

After the surgery is completed, a 30-45 minute recovery process is initiated, and the patient is transferred to their room.

To minimize early postoperative pain, the patient is given combined method anesthesia (epidural block + general anesthesia) or postoperative PCA follow-up. Elevation and cold application are started immediately.

The patient’s general evaluation is repeated daily, and rest and in-bed exercises are recommended. The first mobilization and exercises are taught with the assistance of a physiotherapist. Postoperative X-ray

Day 4: Exercises and general check-up

Day 5: Discharge and transfer to the hotel by ambulance

Long-Term Follow-up

Teaching the patient how to perform lengthening and monitoring its applicability (video)

Physical therapy (with a physiotherapist and independent exercises)

X-ray follow-ups (every 15 days) Doctor visits (via video motorcycle)

Advantages

Minimal invasive Minimal pain Minimal infection risk due to no connection with the external environment Disadvantages

High cost (compared to fixator methods) Use of a wheelchair due to a lower weight-bearing capacity (in these patients, the use of Stride brand nails may be more appropriate) Why Should I Choose the Precice Method?

Lengthening and comfortable completion of the consolidation process with a single surgery Easier physical therapy process Minimal invasive Less scarring (small incisions and aesthetic stitches) Minimal infection risk Minimal need for bandaging

Why Shouldn’t I Choose Precice?

Nail removal requirement Expensive method Weight restrictions