case_images: PMC5932753_01
case_images: Initial clinical presentation and long leg alignment films demonstrating a 3 cm leg-length discrepancy
case_images: 13037_2018_154_Fig1_HTML.jpg
case_images: PMC5932753_01_13037_2018_154_Fig1_HTML.jpg
case_images: Fig1
case_images: She acquired a leg length discrepancy of 30 mm, right shorter than left, had right hip pain, walked with a limp and complained of symptomatic hardware about her hip (Fig. 1).
case_images: Post-operative portable films of right femur with PRECICE  nail
case_images: 13037_2018_154_Fig2_HTML.jpg
case_images: PMC5932753_01_13037_2018_154_Fig2_HTML.jpg
case_images: Fig2
case_images: She underwent a proximal femoral osteotomy and placement of a 10.7 mm antegrade PRECICE  expandable femoral IMN (Fig. 2).
case_images: Long leg weight-bearing plain films demonstrating femur after one week of lengthening
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case_images: PMC5932753_01_13037_2018_154_Fig3_HTML.jpg
case_images: Fig3
case_images: She was followed weekly with physical exams and plain film radiographs (Fig. 3).
case_images: Long leg weight-bearing plain films demonstrating femur after four weeks of lengthening
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case_images: PMC5932753_01_13037_2018_154_Fig4_HTML.jpg
case_images: Fig4
case_images: Bilateral long leg Weight-Bearing (WB) plain films demonstrated that the right femur was within 2 mm of length compared to the left femur (Fig. 4) and regenerate was visible in the osteotomy gap.
case_images: Long leg weight-bearing plain films demonstrating femur at eight weeks after lengthening with mechanical shortening of nail
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case_images: PMC5932753_01_13037_2018_154_Fig5_HTML.jpg
case_images: Fig5
case_images: Plain films demonstrated a 25 mm leg length discrepancy (Fig. 5).
case_images: Enhanced view of distal nail, with a red circle demonstrating flaring of the nail flange that was not present in previous films
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case_images: PMC5932753_01_13037_2018_154_Fig6_HTML.jpg
case_images: Fig6
case_images: Closer inspection of the radiographs revealed that the flange of the nail was flared distally (Fig. 6) and the lengthening mechanism had failed.
case_images: Long leg weight-bearing plain films demonstrating femur at ten weeks after restarting lengthening
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case_images: PMC5932753_01_13037_2018_154_Fig7_HTML.jpg
case_images: Fig7
case_images: She continued the protocol and stayed non-WB for the duration of her lengthening, however only an additional 5 mm were gained (Fig. 7) as the mechanism would not lengthen any further, presumably due to the mechanical failure.
case_images: Final construct after exchange nailing. Most recent films from January 2016
case_images: 13037_2018_154_Fig8_HTML.jpg
case_images: PMC5932753_01_13037_2018_154_Fig8_HTML.jpg
case_images: Fig8
case_images: Her osteotomy went on to nonunion and she eventually underwent exchange nailing (Fig. 8).