Taking the Pain Out of Walking



Photo by Daniel Smyth

Many of us take the ability to walk barefoot along the beach, or the simplicity of slipping on a pair of flip-flops, for granted. 

But walking causes an annoyance or even severe pain for individuals with discrepancies in lower limb length. 

John Wyrick, MD, orthopaedic surgeon at University of Cincinnati Medical Center, director of orthopaedic trauma for UC Health and professor of orthopaedic surgery for UC College of Medicine, is performing a less-invasive method of limb lengthening that uses new technology. It’s called the PRECICE® system, using an intramedullary nail and an external remote controller. The nail is typically surgically placed inside the femur or tibia, which are relatively hollow bones. 

“This advance in technology allows us to insert these nails inside the bone once it’s cut, then it’s slowly pulled apart one millimeter a day,” says Wyrick. “So over time, the bone lengthens and fills in.” 

Limb lengthening uses the body’s natural ability to heal itself. The patient is in control of lengthening the bone at home, with the use of the magnetic controller, which communicates with the magnetic motor located inside the nail. 

Prior to this technology, limb lengthening procedures were performed using pins attached to bulky external devices. “This process is much less painful for patients, and reports indicate fewer complications resulting from infection,” says Wyrick. “The new procedure is also better equipped at guiding the bone into alignment as it grows.” 

Wyrick explains that limb length discrepancies occur from a variety of circumstances. “It could be of traumatic origin, fractures that healed in a shortened position, or a young person could have injured a growth plate which causes shortening. Additionally, some patients are born with congenital limb deficiencies.” 

Each patient differs in terms of the amount of lengthening required, and limbs are precisely measured using X-rays. Wyrick notes most patients use shoe lifts to relieve the back and hip pain resulting from limb length discrepancy, but that is a temporary solution. 

The future of this technology will eventually include arm lengthening as well – a rod for the arm is currently going through FDA approval. 

Wyrick leads a five-year orthopaedic surgery residency program at the University of Cincinnati, training five residents each year. He has received several awards and is published in many medical publications while conducting research in his fields of expertise.

University of Cincinnati Medical Center is located at 234 Goodman Street, Cincinnati, OH 45219. You can reach them at 513.584.1000 or visit their website at www.UCHealth.com/University-of-Cincinnati-Medical-Center.