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[Ozymandias]

I recently came across this article (published April 2016) by our well-known Dr. Birkholtz: "Evaluation of the first experience of intramedullary nail lengthening using PRECICE® in a South African limb lengthening and reconstruction unit"

http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S1681-150X2016000100009

I think it is an interesting lecture for us the future LLers. I recommend reading it entirely, but as a brief resume, a total of nine patients underwent the limb lengthening procedure in 11 limb segments. Average lengthening was 45.18 mm (15 to 65 mm range)

Two points I found particularly interesting:

- There were 2 complications (2 out of 9... higher ratio than other studies I found). One of them does not worry me, honestly, as happened in a previously lengthened part of the bone (quite strange) The second was a failure of nail distraction during femoral lengthening (apparently caused by an insufficient reaming), so the nail had to be replaced... I wonder if the patient was charged for this.

- In the discussion, Dr. Birkholtz defends the use of PRECICE over other intramedullary nails. However, the links provided to defend this claim (when compared to Fitbone) do not really convince me. Curiously (or maybe not) I think I am still to find an article about a particular intramedullary nail that does not end with a strong recommendation of that nail...

Hope this is interesting for someone!

[Antonio]

That's a great post Ozy! I didn't know that the PRECICE was recently FDA approved, not even the ELLIPSE website mentions it.

I won't be too worried about the 2/9 complication rate; the sample size was not significant (you need a minimum of about 30) and it was the first batch of patients by Dr. Birkholtz.

Unfortunately they didn't give details of their "aggressive post-operative physiotherapy regimen" although I question that the mentioned supposed advantage over the Fitbone with regards to ROM has anything to do with the nail.

What would be interesting to see would be the same doctor operating on the same patient with Fitbone and PRECICE in different femurs.

[onemorefoot]

The main advantage of Precice 2 over Fitbone is the accuracy in amount lengthened and real amount ,is almost 1:1, with Fitbone it is more inexact, for several mm.

[Ozymandias]

What would be interesting to see would be the same doctor operating on the same patient with Fitbone and PRECICE in different femurs.

I offered myself as a volunteer if there is some kind of... incentive 

[LLuser1]

I agree. Precice is the best intramedullary nail. Fitbone is extremely inaccurate according to patients themselves

I have been measuring my height the last days but my height gain didnt match with the lengthened amount.

(From Krp1 diary December, 11 2015)

Given both options, I would go with the Precise II. I think it is the better and more accurate nail overall. I have heard slightly more people complain about Fitbone gains vs Precise II gains, though it is hard to determine the exact reasons for failure or the amount missing per mm turned.

(From PatientZero December, 29 2015)

ChrisIsaak said the same and many other Fitbone patients

[LLuser1]

It's ironic you're defending Fitbone. I don't care about those Precice sources. Aren't there articles about Fitbone? If there were they would say Fitbone is worse. How many implants failed just on you?