Methods & Devices

PRECICE is a fully internal magnetic nail that is lengthened non-invasively with an external remote controller. LON (Lengthening Over Nail) combines an internal nail with an external fixator during the distraction phase. PRECICE generally offers more comfort, while LON may reduce costs and allow faster weight-bearing in some protocols.

The main categories include internal lengthening nails (PRECICE, STRYDE, Fitbone), external fixators (Ilizarov, Taylor Spatial Frame, monolateral frames), and combined approaches such as LON and LATN. Each has specific trade-offs related to comfort, complication profile, weight-bearing ability, and cost.

The choice depends on anatomy, cosmetic goals, and risk tolerance. Femur lengthening generally has lower nerve-related complication rates but changes the sitting-to-standing proportion. Tibia lengthening affects visible leg length more directly but carries higher peroneal nerve risk. Some surgeons recommend femur first for cosmetic cases.

The typical sequence includes pre-operative planning and imaging, the osteotomy surgery with device placement, a latency period (5-10 days), the distraction phase (approximately 1 mm/day), and the consolidation phase where new bone hardens. The full timeline varies by method and lengthening amount.