Comparison of Precice and Ilizarov Techniques in Limb Lengthening Surgery
Limb lengthening surgeries are frequently chosen procedures, especially for congenital short stature, traumatic causes, or cosmetic purposes. With advances in technology, the methods used for these operations have diversified. In this context, the traditional and long-applied Ilizarov technique and the recently preferred modern implant system known as the Precice method stand out. This article will thoroughly discuss the characteristics, advantages, disadvantages, and clinical application differences of both methods.
Ilizarov Technique
The Ilizarov method is an external fixation system consisting of rings and rods developed by Soviet orthopedic surgeon Gavriil Abramovich Ilizarov. This system operates on the principle of controlled, gradual bone distraction following a surgical osteotomy. After the bone is cut, the patient’s bone tissue rapidly regenerates, enabling new bone formation.
Advantages of the Ilizarov technique include relative surgical simplicity, lower cost, and high flexibility, particularly in deformity corrections. The Ilizarov apparatus is effectively used not only for lengthening but also for non-union cases, bone infections, and deformity surgeries.
However, there are some drawbacks to this method. Patients must live with the ring fixator during treatment, which reduces daily comfort. There is a risk of skin infections in the device area, the apparatus can be heavy, and maintenance can be challenging. Additionally, the healing and rehabilitation periods may be prolonged.
Precice Technique
The Precice method is a cutting-edge, magnetically controlled intramedullary (inside the bone) lengthening system. In this technique, an internal extendable rod implanted inside the bone is lengthened by electromagnetic waves applied externally. Unlike the Ilizarov technique, no external fixator or device is used.
Its advantages include a minimally invasive process and the device being completely internal, allowing patients significantly more freedom in daily activities. The risk of infection is notably lower than with external fixators. Furthermore, the lengthening procedure can be performed in a controlled, patient-friendly manner with an external magnetic controller. Postoperative comfort and aesthetics also favor this method.
On the other hand, the Precice system is considerably more expensive than the Ilizarov method. There are also technical limitations, such as suitability regarding bone thickness and structure. Patient eligibility must be carefully evaluated before the procedure. Furthermore, vigilance is required to avoid mechanical failures, and regular monitoring is essential.
Clinical Application and When to Prefer Which Method?
The choice of technique depends on factors such as the patient’s age, bone structure, amount of lengthening, socioeconomic status, and personal preference. The Ilizarov method is preferred particularly in complex deformity corrections, severe infection cases, or low-budget conditions, while the Precice method is more suitable for cosmetic limb lengthening, patients with a low risk of infection, and those seeking shorter rehabilitation periods.
While the Ilizarov device is observed to be more durable in longer lengthenings, Precice shows effectiveness as an innovative solution. In both methods, patient compliance with regular medical check-ups, physical therapy, and rehabilitation programs significantly enhances treatment success.
The decision should be made jointly by the surgeon and patient, considering technical details, patient satisfaction, complication risks, and quality of life. With advancing technology, the use of magnetically controlled systems like Precice is expected to become more widespread.