The method that reduces the scar in lengthening: Precice 2

The Precice 2  method is a method used in lengthening surgery, and in this method, it is possible to lengthen the bones by cutting the tibia and thigh bone (femur) and placing a hollow device. As in every surgical operation, scars remain in the body in lengthening operations. However, after lengthening surgeries performed with the Precice 2 method, smaller and indistinct scars occur compared to other methods.

Regardless of the surgical operation, one of the most important concerns of the patients is to be healthy as before, and the other is whether there will be any scars. Scars depend not only on the size of the incision, but also on the characteristics of the area where the surgery will be performed, the skin structure of the patient and the healing process. Therefore, even with the Precice 2 method, the scars cannot be completely removed, but they will be much smaller and less obvious than the scars formed by other methods. In the post-operative period, wound healing should be followed up and care should be taken.

What is the PRECICE 2 method?

The most commonly used method in lengthening surgeries, Precice 2, is based on the extension of nails placed in the bone with the help of a remote control. In addition to increasing patient comfort, there are no externally applied devices. However, the method does not provide full weight bearing like the external fixator method, and it is a more expensive method than the combined method. 

The operations performed with the Precice 2 method take approximately 3-4 hours, and these operations are performed under general or regional anesthesia. A motorized nail is inserted into the marrow cavity of the bone by entering through small incisions, and these nails are produced individually. After the newly formed bone is completely fused, the nail inside can be removed with an additional operation. When applied to the lower and upper legs at the same time, an elongation of 12-13 centimeters is achieved. It achieves an average of 6-8 centimeters of lengthening in a single session.

What are the advantages and disadvantages of the Precice 2 method?

Precice 2 has many advantages. The nails used in this method are produced individually. Since the method is applied closed, the risk of skin infection is almost non-existent. No external device is worn, patients can easily wear the clothes they want, take a shower and swim. Since it is a closed method, it does not need to be dressed every day, it does not cause discomfort both in daily life and at night. Therefore, the comfort of the patient is higher.

Each method has advantages as well as disadvantages. This method is more costly than the combined (LON) method. If any problem arises, it is not possible to make any external intervention to the Intramedullary nails inserted into the bone for lengthening. 

There is a limitation of movement as there is a gap between the two bones due to lengthening and it is necessary to wait for this gap to be filled. Since the lengthening process is done every day, the patient has to keep the extension control with him at all times. As in the LON method, there is no system that will carry the entire burden of the patient. During the treatment process, patients have to use a wheelchair. Since the patient cannot walk easily and cannot use the extended limb, weakness may occur in the muscles. Because of this weakness, physical therapy should be applied regularly.