Innovative approach to limb lengthening!

Limb Lengthening by Precice 2 involves a sophisticated remote control method utilizing a magnetic nail (developed by Nuvasive) inserted into the bone. This innovative approach ensures a comfortable limb lengthening experience without any external visibility. This innovative system utilizes an intramedullary nail inserted into the bone, allowing for precise and controlled lengthening of the bone using an external remote control (ERC). This technique eliminates the need for external fixation, which can be uncomfortable and unattractive for patients.

One of the significant advantages of the Precice 2 system is that it offers a more comfortable and less painful experience for patients compared to traditional limb lengthening methods. The procedure is performed with small incisions, resulting in minimal surgical scars and pleasing patients with aesthetic concerns

The Precice 2 nail, made of biocompatible titanium, provides support to the bone during the lengthening process. However, it cannot bear the full weight of an adult patient. Therefore, patients must use a wheelchair during the distraction phase.

The Precice 2 system also reduces the risk of complications associated with limb lengthening surgery, such as infection and nonunion, as it allows for both lengthening and shortening of the bone. Once the newly formed bone is fully consolidated, typically one to two years after surgery, the nails can be removed with a minor procedure.

The Precice 2 method involves daily lengthening of the bone using the titanium nail and the ERC device. The lengthening process is performed three times daily, with each session consisting of 0.33 mm. The total duration of the distraction phase varies depending on the desired height gain, with 60 days required for gaining 6 cm and 80 days for gaining 8 cm. During this phase, the surrounding soft tissues are also lengthened through physiotherapy and exercise.

Components of Precice 2

Intramedullary Nail;

Intramedullary nail, or rod is used as an internal fixation and is made of titanium alloy. The doctor decides the size of the nail by reviewing the X-ray images. (8,5 mm, 10,7 mm, 11,5 mm or 12,5 mm) During the operation, it is surgically embedded into the bone cavity. As the nail is biocompatible, it does not contain any elements that will cause harm to the body.

External Remote Controller (ERC);

External Remote Controller is a portable magnetic device that makes the elongation occur by pushing the button on it. Thus, controlled lengthening phase is provided thanks to it.

Advantages of Precice 2

1. Safe and precise method of limb lengthening.

2. Allows height increase up to 6 cm in tibia and 8 cm in femur.

3. Eliminates need for external fixation and reduces risk of infection.

4. Allows for greater freedom of movement during recovery.

5. Allows for normal walking within 4-5 months.

6. Leaving fewer and less visible scars.

7. The remote-controlled lengthening mechanism allows for precise adjustments, millimeter by millimeter, leading to a more controlled and predictable outcome.

Disadvantages of Precice 2

1. Precice 2 may slow down bone healing as weight bearing is limited during the healing phase, but patients receive physiotherapy and perform exercises to promote healing.

2. Requires use of a walker or wheelchair during the lengthening phase.

3. Cost may not be affordable for all patients.

Important Information regarding the nail: Patients weighing between 40-70 kg are authorized to ambulate with the aid of a walker, contingent upon the dimensions of the nail and the limb undergoing treatment. However, patients are permitted to engage in ambulatory activities that impose minimal stress on the nail under the supervision of a medical professional. For example, visiting the restroom or participating in ambulation exercises during physiotherapy sessions. Furthermore, a wheelchair should be utilized throughout the elongation phase due to the load-bearing capacity of the nails. This precaution is essential to prevent potential damage to the mechanism resulting from excessive pressure on the lower extremities.