Today in leg lengthening surgery, instead of external fixators, internal fixators that are placed inside the body (leg bone) and can be controlled from the outside are applied. There are also techniques in which both internal and external methods are combined.
Internal methods with specially developed nails do not require external stabilization and therefore offer greater mobility and functionality during the lengthening process.
In the external method, orthopedic limb lengthening devices that remain outside of the body are applied. There are external stabilizers such as TSF (Taylor Spatial Frame), Ilizarov device etc.
Orthopedic lengthening devices placed inside the bone and controlled externally are called ”internal devices”; like Precice®. In this method, since there is no part remaining outside the body, it does not restrict movement.
Precise® is an orthopedic lengthening nail (intramedullary nail) that consists of a telescoping metal rod. It is inserted through a small incision into the bone canal. After the surgery, a special remote control is given to the patient. When this remote control is placed against the leg, the magnets inside it slowly extend the magnetic motor in Precice®. When the nail lengthens, the leg bone also lengthens.
Precice® nails may have different lengths and diameters, but the patient’s bone structure should be appropriate. The bone diameter must be wide enough for the nail to fit inside the bone canal. The bone also should be long enough to fit the Precice nail. The shortest Precice® nail length is approximately 160-170 mm for the shin and femur. For this reason, the surgery decision is made after X-ray examination to see if the bone is long enough to the nail. Precice® is accurate and controllable limb lengthening method . It can be programmed to aid rapid recovery.
It is the use of internal and external techniques together. An intramedullary nail is used with a fixation system outside the skin. The disadvantage of this technique is the increased risk of infection due to the use of two implants. Also, three operations are required; first to place the nail and the external fixator, secondly to remove the external fixator and lock the nail, and finally to remove the nail.