Tibial Bone Loss Treated with PRECICE Bone Transport Intramedullary Nail

Distraction osteogenesis is a well-established technique for the management of critical-sized bone defects. A segment, or segments, of bone can be transported through the defect, producing regenerate and eventually an intact bone. Traditionally, bone transport has been performed using circular thin-wire external fixation as popularized by Ilizarov. With advancements in technology, other forms of circular external fixation such as hexapod external fixators, circular fixation with cable pulley transport, and integrated techniques such as transport over a nail or transport and then nailing are also viable options. Kold and Christensen first described a technique for all-internal bone transport using a motorized intramedullary nail (IMN) Kold and Christensen (Acta Orthop 85:333, 2014). Since then, other devices and techniques for all-internal transport have been developed. Bone transport with an all-inside implant avoids external fixation and the associated wires and/or half pins moving through the skin. This would obviously reduce the incidence of pin track infections but may also increase patient comfort, reduce pressure on soft tissue flaps, and improve rehab potential. Here we present a case of a segmental tibial defect treated with a motorized intramedullary transport nail.