Retrospective multicentre study of 26 pediatric patients (<18 years) treated for limb length discrepancy ≥30 mm with the PRECICE 2 magnetically driven intramedullary nail at three Italian tertiary centers (2014–2017). The study evaluates achieved lengthening, nail performance metrics, ASAMI outcomes, and complications classified by Paley's system. The central question is whether this device delivers accurate, safe lengthening in skeletally immature patients compared to external fixation.
A patient with limb length discrepancy and a history of hip dysplasia treated with pelvic or proximal femoral osteotomy is not a straightforward candidate for intramedullary lengthening. Plain radiographs can miss acetabular retroversion and posterior wall deficiency — exactly the anatomy that leads to progressive hip subluxation during distraction.
When you are planning PRECICE 2 femoral lengthening in any patient with prior hip dysplasia surgery, get a preoperative CT to assess acetabular morphology before committing to the nail.
For patients without hip pathology, the PRECICE 2 delivers reliable lengthening (91% accuracy, 93% excellent bone scores) with no weight-bearing during distraction and only 25% weight-bearing during consolidation. Joint contractures. The most common problem at 19%. Respond to slowing the distraction rate and escalating physiotherapy without reoperation.
The trochanteric tip entry point is non-negotiable in skeletally immature patients. Piriformis fossa entry risks the medial femoral circumflex artery. Zero AVN cases in this series (and in Hammouda's 28-patient series) confirm trochanteric entry is safe in children.
Clinical Results and Complication Rates of Lower Limb Lengthening in Paediatric Patients Using the Precice 2 Intramedullary Magnetic Nail: a Multicentre Study
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Retrospective multicentre study of 26 pediatric patients (<18 years) treated for limb length discrepancy ≥30 mm with the PRECICE 2 magnetically driven intramedullary nail at three Italian tertiary centers (2014–2017). The study evaluates achieved lengthening, nail performance metrics, ASAMI outcomes, and complications classified by Paley's system. The central question is whether this device delivers accurate, safe lengthening in skeletally immature patients compared to external fixation.
A patient with limb length discrepancy and a history of hip dysplasia treated with pelvic or proximal femoral osteotomy is not a straightforward candidate for intramedullary lengthening. Plain radiographs can miss acetabular retroversion and posterior wall deficiency — exactly the anatomy that leads to progressive hip subluxation during distraction.
When you are planning PRECICE 2 femoral lengthening in any patient with prior hip dysplasia surgery, get a preoperative CT to assess acetabular morphology before committing to the nail.
For patients without hip pathology, the PRECICE 2 delivers reliable lengthening (91% accuracy, 93% excellent bone scores) with no weight-bearing during distraction and only 25% weight-bearing during consolidation. Joint contractures. The most common problem at 19%. Respond to slowing the distraction rate and escalating physiotherapy without reoperation.
The trochanteric tip entry point is non-negotiable in skeletally immature patients. Piriformis fossa entry risks the medial femoral circumflex artery. Zero AVN cases in this series (and in Hammouda's 28-patient series) confirm trochanteric entry is safe in children.