CAYMAN ISLANDS - For the first time in the Caribbean, surgery using a novel "magnetic nail" device has resulted in less pain and improved walking ability for a long-suffering patient.
Health City Cayman Islands Chief Orthopedic Surgeon, Dr. Alwin Almeida and his medical team at Health City were the first doctors in the region to use the device - which is currently available in the United States but had not been previously used in the Caribbean or Latin America.
Caymanian Robert Smith was in pain for more than 20 years as a result of a car accident which left his right femur, or thigh bone, shorter than the left.
It was during a recent post-operative period following surgery at Health City Cayman Islands to correct an extensive left shoulder rotator cuff tear that he mentioned his prior injury to Dr. Almeida.
Patient Robert Smith is back at work and continuing physiotherapy after his limb lengthening surgery.He disclosed that one of his femurs was about an inch shorter than the other. The shortening of the limb resulted in severe pain, as well as damage to his hip and knee joints despite multiple surgeries over the previous 15 years.
"It was actually what people might call a coincidence. I call it a blessing," recalled Smith. "I'd actually torn my left rotator cuff about a year-and-a-half ago and went immediately to Health City and that's where I met Dr. Almeida. He took very good care of me and everything is working great and [while] getting treatment for that injury, I told him what had happened to my leg."
Dr. Almeida had previously performed a number of limb lengthening procedures in India using the Ilizarov apparatus, which involves wires and pins cutting through skin, occasionally resulting in pin site infections and other complications.
But after reviewing Smith's case, the doctor felt that he would be a good candidate for an innovative, less invasive and less complex limb lengthening surgery informally known as the "magnetic nail" procedure, which had recently become available in the United States.
These screens show the telescoping magnetic nail in place following the surgery. The magnetic nail procedure, Dr. Almeida said, "allows the same lengthening without disturbing the normal anatomy of your body. It is a minimally invasive technique to insert the nail into the body with small puncture wounds. That's all there is, and even though we need to cut the bone, that is done through a minimally invasive technique."
Dr. Almeida added that "once the bone is cut, it is gradually lengthened over a period of time every day by about a millimeter and that causes more bone to form in between as it's gradually distracted ... using a magnetic nail."
The magnetic nail technique, Dr. Almeida pointed out, has benefits other than pain relief and limb lengthening: "So when you have people who want to increase their height for cosmetic reasons you wouldn't want to put Ilizarov wires sticking outside of a limb reconstruction, because it will cause scars of your skin muscles and soft tissues. This minimally invasive technique is cosmetically very pleasing apart from the advantage of reliable lengthening without disturbing too much of the anatomy."
As for his first magnetic nail procedure patient, Dr. Almeida said: "His prognosis is good. Right now, he has achieved the bone union and we are in the consolidation phase where we are allowing the regeneration to consolidate and it's reaching a stage where there is more and more bone forming in there. I will leave the nail inside for another year before I take it out."
Robert Smith greets orthopedic surgeon Dr. Alwin Almeida during a follow-up visit after his surgery.Likewise, Smith is delightedly adjusting to his newly heightened life: "I don't feel my body being imbalanced. I am still working on my gait or the way that I walk and that's simply because of just really getting used to a new leg. It's weird for so many years I have been so used to walking imbalanced so my body is basically learning how to walk balanced again."
As he gets accustomed to living with less pain and imbalance, he praised the care and attention he received at Health City Cayman Islands: "In terms of professionalism and capability I don't think I could ask for better. They've gotten the job done, but more than that, just interacting with Dr. Alwin and the medical team has been a joy because they make you feel comfortable. They actually have an excellent way of asking you questions. You can see that they really have a concern about you as a patient and I think that's what makes the difference.''
