Research summary
A comprehensive review of all major internal nail technologies for limb lengthening, from early mechanical nails to modern magnetic systems. Covers LON, LATN, PRECICE, FITBONE, and extended indications including bone transport and deformity correction.
Published in Strategies in Trauma and Limb Reconstruction, this review by Barakat and colleagues provides a comprehensive overview of all major intramedullary nail technologies used for limb lengthening. It traces the evolution from early mechanical devices (like the ISKD) to modern magnetic nails (PRECICE), and covers the full spectrum of surgical approaches including lengthening over a nail (LON) and lengthening and then nailing (LATN).
| Device | Mechanism | Key advantages | Notable concerns |
|---|---|---|---|
| PRECICE | Magnetic, external remote controller | 96% accuracy, lower complication rate | Cost, weight-bearing restrictions (older models) |
| FITBONE | Motorized, electromagnetic induction | Strong track record in Europe | Availability limited to certain regions |
| ISKD (older) | Mechanical, ratchet-based | No external controller needed | 21% failure rate, runaway nail risk |
LON (Lengthening Over a Nail) significantly reduces the time patients need to wear an external frame and shortens the consolidation period compared to traditional Ilizarov methods. LATN (Lengthening And Then Nailing) can reduce external frame time to approximately one-quarter of what conventional approaches require. Fully internal magnetic nails eliminate the external frame entirely, offering 96% accuracy for the PRECICE compared to the ISKD's much higher complication rate of 74.3%.
This review provides a clear roadmap of how limb lengthening technology has evolved. Older mechanical nails had high failure rates and were difficult to control precisely. Modern magnetic nails (especially the PRECICE system) are far more accurate and reliable. The review also discusses newer applications of these nails beyond simple lengthening, including bone transport for large defects and simultaneous deformity correction, showing how the technology continues to expand its usefulness.
Informational only. Not medical advice.