NICE has been notified about this procedure and it is part of its work programme. The Interventional Procedures Advisory Committee (IPAC) will consider this procedure and NICE will issue an interventional procedures consultation document about its safety and efficacy for 4 weeks’ public consultation. IPAC will then review the consultation document in the light of comments received and produce a final interventional procedures document, which will be considered by NICE before guidance is issued to the NHS in England, Wales, Scotland and Northern Ireland.
 
Status In progress
Process IP
ID number 358
Description IM distraction systems are used for managing fractures. Once inserted and fixed they can be mechanically lengthened over time using different technique. The aim is to lengthen the bone in a controlled manner. With this procedure, under general anaesthesia, an osteotomy is done while avoiding damage to the periosteum and its blood supply. The adjustable IM nail-like device is then implanted into the IM space. Its proximal and distal sections are then fixed to the relevant section of the bone with sterile locking screws. Once implanted and fixed, the device can be adjusted in length to provide an appropriate amount of compression and allow bony alignment at the osteotomy site. It exerts a force along the long axis of the bone, which stimulates new bone formation (distraction osteogenesis) in the gap, causing bone lengthening. Over days, weeks or months, sequential distractions are used to produce the target limb length. Different devices achieve distraction in different ways. For example, some work mechanically by releasing a preloaded spring or using a motor driven extension. Others are non-invasive and use an electromagnetic external device. Soon after the procedure, with help from the therapy team, people are able to partially weight bear. The IM device then remains implanted until bone consolidation is complete. When there is radiological evidence of adequate bone consolidation across the gap, full weight bearing is possible. The device is then usually removed using standard surgical techniques.

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Timeline

Key events during the development of the guidance:

Date Update
21 October 2021 - 18 November 2021 Interventional procedure consultation

For further information on how we develop guidance, please see our page about NICE interventional procedures guidance