Limb Lengthening – PRECICE nail

What is the PRECICE  Lengthening Nail

The PRECICE Lengthening Nail is an internal rod or device used to lengthen a long bone (such as femur, tibia or humerus). It can be used for lengthening a shortened bone after trauma, infection, disease and for a congenitally shortened bone.

The PRECICE Lengthening nail is a two-part telescopic rod with a magnetic distraction component (lengthening device) used together with an External Remote Controller (ERC). The lengthening programme of the nail is prescribed by your surgeon and is based on your clinical assessment (check up) and X-ray measurements taken at your clinic appointments.

How does the PRECICE Lengthening Nail work?

During anaesthetic the nail is inserted into the center/hollow canal of the shortened bone such as femur (thigh bone) or tibia (shin bone) and held into place with screws at each end.  Then small surgical incision/s (cuts) are made through which the surgeon cut the bone/s. This is referred to as a corticotomy/osteotomy.  The surgical wounds are then sutured (stitched) with dissolvable sutures and covered with waterproof dressing/s.

Between day one and three post insertion of the nail you will have a repeat X ray to check the position of the nail and once you have adequate pain control and have been cleared by the physio you will be discharged home with a follow up date with the team between 10-14 days.


At the first postop visit your surgical team will remove the dressings and sutures and the lengthening will commence using the ERC.

Lengthening is achieved by following demonstrated instruction regarding the lengthening technique with the ERC and the exercise regime provided.  Over the next few days and weeks the two ends of the telescopic rod (nail) slowly pull apart creating a gap in the bone. This phase is referred to as the Distraction phase (lengthening phase). You can expect to be reviewed at least fortnightly during this lengthening process/phase with X rays taken at each visit to access your progress of distraction (lengthening / correction) while mobilising (walking) on crutches with minimal weight bearing to protect the nail and new bone.

Once the nail is out to length the distraction phase is complete however osteogenesis (creation of new bone in the gap) continues. This is referred to as the Consolidation phase (hardening of the new bone formed in the gap).  At this point you would be expected to come for review once a month, with ongoing physiotherapy at home while back at work / study at least part time. You would remain on crutches and slowly increase weight bearing status as the bone consolidates in the gap. The team will advise when you can commence full unrestricted weight bearing and this judgement is based on the X-ray and clinical appearances. Once the bone is consolidated (hardened) the team will request less frequent follow up appointments and you will be encouraged to mobilise without crutches gradually.

The Precice lengthening nail allows controlled and precise correction of leg length discrepancies with a higher union rate and lower complication rate than previous lengthening nails.

Please contact our rooms for more information.

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