Limb Lengthening by Precice 2
Precice 2 system (NuVasive Specialised Orthopaedics (NSO)) offers a less-invasive procedure in Limb Lengthening surgery. It has been used since 2011, and has been one of the most preffered method by most patients so far in terms of amenity and biological safety. Elongation is achieved using intramedullary techniques, with nails that are fully implantable in the patient. The two ends of the telescopic nais slowly pull apart creating a gap in the bone. In addition to this, there is no external metal device attached to the legs. These are the most notable advantages over traditional methods used external fixators which have been related to infuriating discomfort, prolonged treatment times, and the risk of pin-tract infections, which may lead to osteomyelitis.
PRECICE 2 nails are American-made intramedullary nails used for limb lengthening. An External Remote Controller (ERC) is utilized to lengthen the nail, which interacts with magnets within the nail.
Components of Precice 2
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.
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.
Important Information about the nail: Patients weighing up to 40-70 kg are permitted to walk with the support of a walker depending on the size of the nail and limb being treated. However, patients are allowed to walk in activities that do not put too much weight on the nail under the supervision of the doctor. For instance, going to toilet or walking exercises in physiotherapy sessions. Apart from this, a wheelchair must be used during the lengthening period owing to the weight-bearing capacity of the nails. Because, the mechanism may be damaged because of putting too much pressure on the legs.
Two Surgeries with Precice 2
If Precice 2 is chosen as a surgery method for limb lengthening, there are two operations that are performed;
- First Surgery; An intramedullary nail is inserted into the medullar cavity of the bone. Patients lengthen the bone gradually by 0,99 mm per day by pushing the button on ERC. (Lengthening is carried out three times a day / 0,33 mm x 3)
- Removal Surgery for Intramedullary Nails; Intramedullary nail can be removed upon patient’s request after the full bone consolidation is completed. It can take a year or one and half years to get rid of the nail with a short procedure.
Advantages and Disadvantages of Precice 2 Method
Advantages;
- It offers less invasive procedure, and less painful process compared to classical methods.
- It bears less risk of getting infection since there is no external devices attached to the legs. (e.g. LON)
Disadvantages;
- The surgery cost is pricy comparing to the other methods such as LON and Holyfix.
- As the weigh-bearing capacity of the nail is limited, patients must use a wheelchair during the lengthening phase. Therefore, some patietns consider choosing Stryde Method to avoid using a wheelchair.
The ‘Precice 2’ methodology is highly preferred by our patients for these simple reasons:
- Patients go through the lengthening process with minimal pain except for the first week.
- Less scar marks will appear on the legs beacuse of the minimal insicions and aesthetic stitches.
- Patients will have less complication, safe and more comfortable lengthening period in comparison to the other methods (e.g LON, Holyfix and Ilizarov)
As a few incisions are made for each leg compared to the classical methods, the scar marks will not be notable too much. The surgical wounds are stitched with dissolvable sutures and covered with waterproof dressings. Nevertheless, the scar marks will fade away as time passes by, and will not be eyeful. Especially, our surgeon ties off stitches aesthetically. If you think you may have sensitive skin against scar marks, you may find out some useful tips for the ways of minimizing the scar marks by watching the video below.
As any other surgery, there are always risks and complications that might occur. As long as the doctor applies the right technique, the hygienic environment is established at the hospital, and proper post-operative care is provided, the risks and the complications are preventable and treatable. As Wannabtaller Team, the first priority is always patients’ safety for us. Yet, every person has unique physiology and some unpredictable conditions might occur such as non bone union or slow bone union. You may visit our blog writing to find out more information related to this issue; "Limb lengthening Side effects, Complications and Risks"
- Assoc. Prof. Dr. Yunus Öç(Istanbul, TURKEY) – 19,850 $ LON method, 47,850 $ intramedullary nail (PRECICE 2.2), Precice Stryde, 16,500 $ limb shortening surgery
- Dr. Paley (the USA) – Bilateral femur lengthening (up to 8 cm of height; cost $97,500 USD,PRECICE-Stryde) / Bilateral tibia lengthening (up to 5 cm of height; cost $109,000 USD, PRECICE-Stryde)
- Dr. Jacob Rozbruch (the USA) – $125,000 (Femur or Tibia) / Nail Removal Fee: $20,000 (Femur or Tibia)
- Dr. Shahab Mahboubian (Hollywood CA, the USA) – Bilateral femur lengthening (Precise nail) – $75,000, Bilateral tibia lengthening (Precise nail) – $85,000 & Combined tibia and femur lengthening 3-4 weeks apart – $155,000
WannaBeTaller - Makbule2023-03-13 11:54
Hello, thanks for your comment. The current total price for Precice 2 + 3-month accommodation would be 55 000 USD. You can have the intramedullary nails removed at another clinic in your country by an experienced doctor in this field, or you can come back here for the removal. The internal nail removal surgery is not included in the surgery price, adn is charged separately. If you are interested in the online consultation, you can book your free online consultation below: https://calendly.com/wannabetaller/wannabetaller-team-online-consultation For fast communication, you can reach us from Whatsapp or Telegram - +90 531 988 30 90 Regards, Wannabetaller Team