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Compare methods side by side

Pick any three techniques and see how they actually differ, from internal magnetic nails to external hexapod frames. No method is "best" in the abstract; the right one depends on your goal and your surgeon.

What it isMagnetically-driven internal nail — the current global standard for cosmetic and reconstructive lengthening.A hybrid technique: external fixator drives distraction while an internal nail provides stability — fixator removed earlier than classical Ilizarov.The original circular-frame external fixator method — workhorse of reconstructive limb lengthening for four decades.
TypeInternal · magnetic nailHybrid (nail + frame)External fixator
StatusCurrentCurrentCurrent
Typical gain5–8 cm5–8 cm3–10 cm
BonesFemur, TibiaFemur, TibiaFemur, Tibia, Humerus
Recovery12–24 weeks16–28 weeks20–40 weeks
Advantages
  • +No external hardware — no pin site infections
  • +Precise, controllable distraction via ERC
  • +Faster return to daily activity than frame methods
  • +Significantly lower implant cost than PRECICE
  • +Shorter external fixator time than classical Ilizarov
  • +Proven track record in high-volume centers (notably Turkey, India)
  • +Proven over 40+ years
  • +Handles complex deformity and reconstruction
  • +Lower implant cost than PRECICE
Trade-offs
  • −Weight-bearing restrictions during distraction phase
  • −Higher implant cost than older techniques
  • −Requires second surgery for implant removal (~12–18 months post-op)
  • −External fixator during distraction (weeks) — pin site care required
  • −Pin site infection risk (manageable but real)
  • −Scarring from fixator sites
  • −External frame for the entire treatment duration
  • −Pin site care intensive
  • −Scarring
MakerNuVasive Specialized Orthopedics (Globus Medical, since Sept 2023)——
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Method is a decision to make with your surgeon based on their experience and your goal, not a shortlist ranking. Ranges are typical figures from published series; individual results vary.

The honest risk picture: complication rates by method and age →
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