May 02, 2012
Dr. Samuel Rosenfeld, an orthopedic surgeon with the CHOC Children’s Orthopaedic Institute, is the first on the West Coast to perform a limb lengthening procedure using the PRECICE™ Remote Control Device. Developed by Irvine-based Ellipse Technologies, in collaboration with Dr. Stuart Green of UC Irvine, and cleared for use in the United States by the FDA in July 2011, the PRECICE represents a new era for limb lengthening.
The device, considered by physicians to be precise and gentle, is implanted with minimal incision surgery. A magnetic motor assembly in a rod is placed inside the patient’s bone and responds to an external remote controller. The surgeon uses the external remote controller to gently and more accurately control the rate of lengthening, including the potential to reverse the lengthening. In addition to providing a less invasive procedure for limb lengthening, PRECICE has been recognized for significantly reducing the potential for complications, such as infections, during the healing process. Presently, the device is used for lengthening the femur and tibia bones.
Leg length discrepancies can be congenital (present at birth) or acquired as a result of an accident, a significant fracture that does not heal or disease, such as cancer. The conventional approach for leg lengthening has been the use of an adjustable external fixation device attached to the bone with pins and adjusted by the surgeon. The leg lengthens as the bone heals. The procedure has been associated with a high rate of complications, most commonly infections at the pin sites.
An alternative to external fixation devices, the first implantable device – called the intermedullary skeletal kinetic distractor (ISKD) – was approved by the FDA in 2001. A telescopic rod implanted in the marrow cavity of the bone and activated by movement, the ISKD makes it more challenging to control the rate of lengthening, potentially resulting in nerve damage, poor bone healing and muscle contractions. With the better control of the PRECICE system, some of these issues may be eliminated.
Named a “physician of excellence” from the Orange County Medical Association, Dr. Samuel Rosenfeld is a pediatric orthopedic surgeon with special interests in muscular dystrophy, spina bifida and spasticity. He received his medical degree from Pennsylvania State University College of Medicine; his internship in general surgery at the University of California Irvine Medical Center, where he also completed his residency in orthopedic surgery; and a fellowship in pediatric orthopedics and rehabilitation at Rancho Los Amigos hospital in Downey, California. He’s part of the multidisciplinary team of experts at the CHOC Children’s Orthopaedic Institute.
The CHOC Children’s Orthopaedic Institute is the only program of its kind in the region offering a wide range of comprehensive subspecialty programs specializing in the diagnosis and treatment of complex orthopedic injury, illness and disorders in children and adolescents. At the CHOC Orthopaedic Institute, highly experienced pediatric orthopedic surgeons and specialists, along with a multidisciplinary team, provide a complete range of clinical, surgical and ancillary support services for our patients in one convenient setting.
About CHOC Children's: Named one of the best children’s hospitals by U.S. News & World Report (2013-2014) and a 2013 Leapfrog Top Hospital, CHOC Children's is exclusively committed to the health and well-being of children through clinical expertise, advocacy, outreach and research that brings advanced treatment to pediatric patients. Affiliated with the University of California, Irvine, CHOC’s regional healthcare network includes two state-of-the-art hospitals in Orange and Mission Viejo, several primary and specialty care clinics, a pediatric residency program, and four centers of excellence - The CHOC Children’s Heart, Neuroscience, Orthopaedic and Hyundai Cancer Institutes. CHOC earned the Gold Level CAPE Award from the California Council of Excellence, the only children’s hospital in California to ever earn this distinction, and was awarded Magnet designation, the highest honor bestowed to hospitals for nursing excellence. Recognized for extraordinary commitment to high-quality critical care standards, CHOC’s Pediatric Intensive Care Unit (PICU) is the first in the United States to earn the Pediatric Beacon Award for Critical Care Excellence.
Denise Almazan, Director of Public Relations
phone: (714) 509-8680