PRECICE vs Ilizarov — side by side.
PRECICE 2 is the modern internal magnetic nail; the Ilizarov apparatus is the original ring fixator that started limb lengthening in Kurgan in the 1950s. One lives inside the bone with nothing to see; the other is worn for the whole distraction and consolidation period and needs daily pin-site care. They are not really competitors for the same patient — which is the point of this page.
| Attribute | PRECICE 2 | Ilizarov |
|---|---|---|
| Hardware | inside bone | outside the skin |
| Cost range | $10,000 – $313,000 (31 clinics publishing a price) | $2,330 – $313,000 (22 clinics publishing a price) |
| Max gain (single stage) | 5–8 cm (femur), 4–7 cm (tibia) | 6–10 cm (femur), 6–8 cm (tibia) |
| Full recovery | 9–14 months | 14–24 months |
| Weight-bearing | 6–10 weeks (partial), 4–5 months (full) | 2–6 weeks (immediate partial), 8–12 months (full) |
| Complication rate | No pooled cosmetic-series rate for PRECICE 2 specifically; Marwan 2020 (795 patients, 11 studies) found no statistically significant complication difference between internal nails, LON and frames. Nail-specific problems: implant failure, premature consolidation, delayed union. | 37% any complication in the largest cosmetic Ilizarov series (Novikov 2014, 48 of 131 patients); pin-site problems dominate, deep infection about 2%, 18% needed a further operation. |
| Scar pattern | 2 small (1–3 cm) incisions per leg, hip + knee | 8–16 pin sites per leg |
| Pin sites | None | 8–16 per leg, on for full duration |
| Popular in | USA, Germany, UK, UAE, Israel, Italy | Russia, India, Iran, Egypt, South Africa |
| Clinics in directory | 94verified | 99verified |
What the published evidence actually supports
The largest published cosmetic Ilizarov series (Novikov 2014, 131 patients, Clin Orthop Relat Res) recorded a complication in 48 patients — 37% — with 18% needing a further operation. Most were pin-site problems and joint contractures; deep infection was about 2%. Those numbers are the honest baseline for a frame.
No pooled cosmetic series exists for PRECICE 2 on its own. Marwan 2020's systematic review found no significant complication difference between nails and frames across 795 patients, so the case for the nail is comfort and the absence of pin-site care, not a proven lower complication rate.
Ilizarov's own 1989 rate-and-frequency study established the 1 mm per day in four steps that every device still uses; the frame's disadvantage is duration — around 20–40 weeks in the device against 12–24 weeks of restricted weight-bearing for a nail — not the biology.
Sources are listed on each method's own page: PRECICE 2 · Ilizarov.
PRECICE vs Ilizarov — which is better?
For a healthy adult seeking cosmetic lengthening with no deformity to correct, an internal nail is what most specialist centres now offer: no frame, no pin sites, a shorter visible recovery. The Ilizarov frame remains the tool for deformity correction, infected non-union, bone transport and any case where the canal cannot take a nail — and it is cheaper, which keeps it common in Russia, India and South America. If a clinic proposes Ilizarov for straightforward cosmetic lengthening, ask why, and ask to see the surgeon's own complication figures.
Clinics offering PRECICE and Ilizarov
- Paley Orthopedic & Spine InstituteWest Palm Beach, Florida
- Hospital for Special SurgeryNew York, NY
- Rubin Institute for Advanced OrthopedicsBaltimore, Maryland
- Acıbadem Healthcare GroupIstanbul (multiple campuses)
- Russian Ilizarov Scientific Center for Restorative Traumatology and OrthopaedicsKurgan
- Center of AnthropometricVolgograd