Downloaded from https://journals.lww.com/techortho by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3K8IvHCABgh8TSuYi0jp4aoEbsr+Bg/Bw2sEd2SqNTeo= on 09/29/2020 Compression of Nonunions With the PRECICE Magnetic Intramedullary Compression Nail Austin T. Fragomen, MD Summary: The magnetic intramedullary lengthening nail can be pre- distracted and used to compress bony interfaces to assist in the healing of nonunions of long bones and to accelerate union at difﬁcult to heal fractures and osteotomy sites. This requires no special implant apart from the lengthening nail. Technical considerations include predis- traction of the nail on the back table, overreaming of the canal, short- ening at the defect site, and applying compression over several days. FIGURE 1. This patient sustained a high energy open femur fracture fixed with an intramedullary nail that was complicated by deep infection. Staged exchange intramedullary nailing with local antibiotics resulted in chronic osteomyelitis and nonunion. A large area of necrotic bone is seen on this radiograph (A). There is a contaminated implant and valgus angulation despite the use of a blocking screw. Preoperative planning included a 10 cm bone resection, limb shortening, and insertion of a PRECICE magnetic intramedullary com- pression nail predistracted 15 mm with an additional blocking screw (arrow) (B). From the Clinical Orthopaedics, Weill Medical College of Cornell University, The Hospital for Special Surgery, New York, NY. A.T.F.: Outside of this work potential conﬂicts include consultant for Smith and Nephew, NuVasive, and Depuy Synthes (J&J). For reprint requests, or additional information and guidance on the techniques described in the article, please contact Austin T. Fragomen, MD, at fragomena@hss.edu or by mail at Clinical Orthopaedics, Weill Medical College of Cornell University, The Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021. You may inquire whether the author(s) will agree to phone conferences and/or visits regarding these techniques. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved. SYMPOSIUM 214 | www.techortho.com Techniques in Orthopaedics$  Volume 35, Number 3, September 2020 Copyright r 2020 Wolters Kluwer Health, Inc. All rights reserved.