Emily's StoryJun 6, 2019
Children’s Hospital of Michigan Orthopedic Surgeon is First in Metropolitan Detroit to Use New Remote Control Device for Limb Lengthening
Emily Seeberg, a 15-year-old resident of Birmingham, Michigan, became the first patient in metropolitan Detroit to benefit from a revolutionary new procedure used to lengthen limbs. The treatment was performed by Ahmed Bazzi, D.O., an orthopedic surgeon, at the Children’s Hospital of Michigan, part of the Detroit Medical Center.
Emily was born with a birth defect called congenital fibular hemimelia where part or all the fibula bone – one of two bones in the calf - is missing. The defect affected her fibula, ankle bone and her little toe. Her right lower leg was significantly shorter than her left leg, and her right foot was also twisted backwards.
Emily’s mom, Brenda, said the condition has caused numerous difficulties.
“She had surgery when she was six-months-old to correct her foot so she could learn to walk. As she grew, the left leg grew normally, but the right leg didn't, and the length discrepancy has grown every year. Her right leg was almost four inches shorter than the left, so she walked with a pronounced limp. The condition has been hard on Emily, and unfortunately she was teased frequently,” Brenda says.
Emily and her family hesitated in proceeding with the traditional treatment method to correct limb length discrepancy because the procedure – the standard option besides amputation -- is cumbersome and painful.
“We have been seeking treatment for years but the options were not good (amputation or the external fixator cuff with pins sticking out of the leg). There is a huge risk of infection with the latter treatment. We would never consider amputation,” Brenda says.
Dr. Bazzi explains that for decades the standard treatment option has been to use an external brace or frame attached to screws with pins that go through the skin and muscle which are then manually turned to lengthen the bone.
“Although it remains a treatment option, it is painful, unsightly and not the most pleasant experience for patients who have to endure the procedure for several months,” Dr. Bazzi says.
Fortunately for Emily, when she checked in with Dr. Bazzi to contemplate undergoing the traditional surgical procedure, Dr. Bazzi had great news that a new option was available using a titanium nail containing a magnet into Emily’s tibia bone. This internal system allows Emily to avoid an external fixator cuff. Instead, it uses a completely internal device that allows patients to gradually lengthen a bone (tibia or femur) while at home.
The Precice™ leg lengthening system by Ellipse Technologies uses a handheld remote control device, powered by rare earth magnets. The device is positioned over the leg bone to manipulate the metal rod and revolving screw gears that have been inserted into the patient's leg bone. This causes the magnet in the titanium nail to rotate, spurring new bone growth.
“Because the lengthening occurs inside the limb, there is less pain, no open wounds, no external brace and a reduced chance of infection,” Dr. Bazzi says.
The device is user-friendly, and patients can gradually lengthen the bone in the comfort of their home. It is typically used three or four times a day until the desired leg length is reached and the frequency is reduced as the lengthening takes place. X-rays are also performed to monitor a patient's progress. Emily is also undergoing physical therapy to lengthen the muscles and tissues along with the bone.
“Emily is making great progress with this new procedure and has gained several centimeters in leg length. Although she will require another surgery in the future to complete the process, she is almost halfway there,” Dr. Bazzi says.
“We feel so fortunate that Dr. Bazzi was able to offer this option to Emily. The process so far seems like a much better alternative than the external fixators. The physical therapy can be painful but our family is so encouraged every time we go to the Children’s Hospital of Michigan and see that the X-rays show how the bone has lengthened,” Brenda says.
“Emily loves to play softball and before this procedure she would need to have someone else run the bases. She is looking forward to running the bases herself one day soon," Brenda says.