Extraction of a Broken PRECICE Bone Transport System: A Case Report and Technique for Residual Limb Salvage
Bibliographic record
Abstract
Aim: To describe a surgical technique for the safe removal of a broken non-cannulated PRECICE bone transport nail (NuVasive Specialized Orthopedics) without compromising limb reconstruction. Background: The removal of broken non-cannulated intramedullary lengthening nails (IMLNs) is challenging. Few techniques have been described for the safe removal of these devices without compromising bone salvage. Case description: A 42-year-old male presented for complex right tibia reconstruction following a type IIIB open tibia fracture with a 92-mm bone defect. The bone defect was initially managed with an all-internal bone transport nail system (PRECICE bone transport). At the 13-month follow-up, the patient presented with a broken lengthening nail, varus limb deformity, and nonunion at the docking site. The nail components were extracted sequentially, and a burr hole was created in the distal segment of the nail through the nonunion site to facilitate removal. The residual varus deformity and tibial shaft nonunion were managed with a hexapod frame. Conclusion: The IMLN was successfully removed without compromising limb reconstruction. By sequentially removing the components of the nail and altering the distal portion of the implant through the nonunion site, safe removal of the implant without further bone loss was achieved. Clinical significance: This report describes an efficient technique for the removal of broken non-cannulated IMLNs when extractors are not available. How to cite this article: . Extraction of a Broken PRECICE Bone Transport System: A Case Report and Technique for Residual Limb Salvage. Strategies Trauma Limb Reconstr 2024;19(3):171-176.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.005 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".