Magnetic leg-lengthening implant gets teenager active again

A four-wheeler ride with family and friends on a gorgeous day in July 2011 took a terrible turn when 11-year-old Michael Duggan unexpectedly wrecked his ATV. “It was a typical ride. There was a birthday party going on at our farm with lots of kids riding around. Michael just lost control of his vehicle somehow,” his father Dan Duggan, of Swanton, Maryland, said.

Dan rushed Michael to the local hospital, where he was transferred to WVU Medicine’s Ruby Memorial Hospital Emergency Department in Morgantown. John Lubicky, M.D., a WVU Medicine pediatric orthopaedic surgeon, examined Michael and x-rays showed that his right femur, or thigh bone, was fractured. The growth plate at the lower end of his right knee was also significantly damaged. Dr. Lubicky realigned the femur, secured the bone with large pins, and applied a cast.

“That night we knew that Michael would have a leg-length discrepancy,” Dan Duggan said. “At 11 years old, we didn’t know how much it was going to be – a little bit or a lot. It was just a waiting game.”

Michael Duggan, age 11, stayed active despite his injury from an ATV accident in 2011.

Lubicky told them that Michael had two options: have his left growth plate removed, so his left leg would remain shorter and match the length of the right leg or wait until he was fully grown and have a rod inserted for a leg-lengthening procedure. The Duggans decided to wait until Michael was fully grown and have his right leg lengthened. When he reached that point, there was a noticeable leg-length difference. “His right leg was about two inches shorter than his left leg, and he had a limp and pain while walking,” Dan said.

Lubicky told the family about a new, less-invasive leg-lengthening procedure, where a magnetically-driven implant is used instead of a bulky metal device worn on the outside of the leg. “This new technology allows us to implant a rod with magnetic motors, and you hold a magnet over top of the area several times a day, and it lengthens the bone,” Lubicky said. “It doesn’t hurt the child because we do it at such small amounts – a third of a millimeter three times a day. Parents can do this at home and are instructed on how to use the magnets.”

At the time, the magnetic implant was not yet FDA approved, and the family's insurance company wouldn’t provide coverage. Lubicky advocated for Michael and told the insurance company why he would benefit from the magnetic implant – less risk of infection without an external device worn on the outside of the leg. “I was just about to go in for the operation for the external device, and the insurance company finally came through,” Michael said. “I give Dr. Lubicky credit for that.”

An x-ray image of the leg-lengthening rod in Michael Duggan's leg

It was a huge sense of relief for the family when Michael was able to get the magnetic implant in November 2015. “I can’t tell you how much sleep I lost over that – weeks’ worth of sleepless nights, worrying about infection, Michael losing his leg, and all of the things that could go wrong with an external device,” Dan said. “It was one of those things that once it happened, you felt like you were blessed."

"Something really special happened to make this new procedure possible for Michael,” his father Dan Duggan said.

Michael is the first patient in West Virginia to undergo leg lengthening with a magnetic implant. “It worked well for us,” Dan said. “Nothing went wrong. It was an absolute gain with a lot less risk and a smoother procedure.”

Michael and Dan also developed a deeper bond from going through this together. “We would talk politics and business on the way to Morgantown,” Dan said. “I’m a police officer and a judge. I’d bring a case study with me, and we’d talk it over. We’ve taken something that’s pretty hard on a young man, made the most of it, and I think we’ve gotten a lot closer because of it.”

Michael, now 16, has been walking without crutches since February, and he doesn’t feel any pain or notice the rod in his leg. He enjoys being active in club sports again at his high school. “It’s almost like it didn’t happen really,” Michael said. “I deal with pain a lot better. This made me stronger.”

Left to right: Dr. John Lubicky, Michael Duggan, and Dan Duggan