FITBONE Internal Nail vs Precice Nail: A Detailed Comparison

If you're researching limb lengthening surgery, you've probably come across two names again and again: FITBONE and Precice. Both are internal, motorized nails. Both promise a life without bulky external frames. And both can sound almost identical when you first read about them.

But they're not the same device, and the difference matters.

Choosing between the FITBONE internal nail vs Precice nail isn't just a technical detail for your surgeon to sort out. It affects how your lengthening process feels day to day, what kind of follow-up care you'll need, and even which centers can offer you the procedure at all.

This guide breaks down how each system actually works, based on published clinical literature and manufacturer data, not marketing claims. We'll look at the engineering behind each nail, recovery expectations, safety records, and the questions worth asking your orthopedic surgeon.

Whether you're dealing with a limb length discrepancy from a previous fracture, a congenital condition, or you're exploring cosmetic height lengthening, understanding the FITBONE vs Precice nail debate will help you walk into that consultation with better questions.

What Is Internal Limb Lengthening, Exactly?

Before comparing FITBONE and Precice, it helps to understand the category they belong to.

Internal limb lengthening uses a rod placed inside the bone (an intramedullary nail) to gradually separate two bone segments after a controlled surgical cut, called an osteotomy. As the gap slowly widens, the body fills it with new bone tissue, a biological process called distraction osteogenesis.

This approach replaced older external fixators, metal frames bolted to the leg with pins through the skin. According to research published via the National Center for Biotechnology Information (NCBI), fully internal nails significantly reduce pin-site infections and allow better joint movement compared to external devices.

Both FITBONE and Precice fall into this internal nail category. Where they differ is how they generate the lengthening force.

FITBONE Internal Nail: How It Works

The FITBONE system was developed in Germany by Prof. Rainer Baumgart and has been used clinically since 1997, making it one of the earliest fully internal motorized lengthening systems.

The Technology Behind It

FITBONE uses an electromagnetic induction system, not magnets. Here's the practical difference:

• A small receiver sits just under the skin, connected to the internal nail.

• An external transmitter (worn like a patch) is placed over the receiver several times a day.

• Electrical energy passes through the skin via induction, powering a tiny motor inside the nail that pushes the bone segments apart.

Because there's no internal battery, the nail itself stays extremely compact.

Key Features

A 2015 clinical study by Küçükkaya and colleagues followed 22 patients undergoing femoral lengthening with FITBONE. The average lengthening achieved was 5.8 cm, with complete bone healing in all but two cases over a two-and-a-half-year follow-up period.

Precice Nail: How It Works

The Precice system, developed by NuVasive Specialized Orthopedics (now part of Globus Medical), received FDA approval in 2012 and has since become one of the most widely used lengthening nails in the United States.

The Technology Behind It

Precice relies on magnetic drive technology:

• A tiny magnetic motor sits fully inside the nail, with no external receiver needed under the skin.

• Patients use a handheld External Remote Controller (ERC), placed against the skin over the nail.

• Rotating magnets inside the ERC cause the internal magnet to spin, gradually extending the telescopic rod.

Key Features

One important safety note: the FDA has issued specific warnings that patients with pacemakers or other active electronic implants should not use magnetic Precice devices, since the strong magnetic field could interfere with those devices.

FITBONE vs Precice Nail: Side-by-Side Comparison

Neither device is universally "better." The right choice depends on your anatomy, medical history, the amount of lengthening needed, and your surgeon's experience with a specific system.

Which One Might Suit You Better?

Consider FITBONE if:

• You have a pacemaker or other electronic implant, where magnetic interference is a concern

• Your surgeon has strong experience with the electromagnetic system

• You need bone transport for a defect, not just lengthening

• You're comfortable with a daily wearable transmitter routine

Consider Precice if:

• You're in the US and want a device with over a decade of FDA-approved use

• You prefer shorter, less frequent charging-style sessions with a handheld remote

• Your case involves standard femoral or tibial lengthening without complex bone loss

• Early full weight-bearing is a priority for you

Safety and Evidence: What Research Actually Shows

Both systems are considered internal lengthening options with generally favorable safety profiles compared to external fixators, according to comparative studies. A 2024 comparative study on lower limb lengthening noted that both PRECICE and FITBONE achieve accurate distraction with external remote controls and strong reported success rates.

That said, evidence directly comparing outcomes between the two systems head-to-head remains limited. Most available data comes from single-system case series rather than large randomized trials, so the American Academy of Orthopaedic Surgeons and similar bodies generally recommend individualized surgical planning over choosing a device based on marketing alone.

Complications reported with intramedullary lengthening nails in general, across both systems, can include:

• Delayed or incomplete bone consolidation

• Axis deviation or angular deformity during lengthening

• Joint stiffness or contracture

• Device-related mechanical issues, though rare with modern models

Your surgeon should walk you through your personal risk profile based on your bone quality, age, and the amount of lengthening required.

Recovery Timeline: A General Overview

While individual protocols vary by clinic and surgeon, a typical recovery pathway looks like this:

1. Hospital stay: Usually a few days after surgery

2. Distraction phase: Gradual lengthening begins around day 5–10, at roughly 0.5–1mm per day

3. Consolidation phase: New bone hardens over several months after target length is reached

4. Device removal: Often required once healing is confirmed on X-ray, sometimes within about a year

Total treatment time, from surgery to full recovery, commonly ranges from 6 months to over a year, depending on the amount of lengthening and individual healing rate.

Frequently Asked Questions

Is FITBONE or Precice more painful? Pain levels are generally similar between the two, since both avoid external pins that cause most discomfort in older fixator systems. Daily lengthening sessions may cause mild, temporary discomfort with either device. Your surgical team will manage this with a structured pain plan.

Can I choose between FITBONE and Precice myself? Your surgeon will usually recommend one based on your anatomy, medical history, and their clinical experience. It's reasonable to ask why a particular device is being suggested for your case.

Is Precice safer than FITBONE? Neither is inherently safer; both have strong safety records when used by experienced surgeons. Precice requires caution around pacemakers due to its magnetic mechanism, while FITBONE's induction-based design avoids that specific concern.

How much can each nail lengthen a bone? This varies by model and bone. Published data shows femoral lengthening of several centimeters is achievable with both systems, though the exact maximum depends on the specific nail model and patient anatomy.

Do both nails need to be removed later? Often yes, particularly for Precice, where FDA guidance recommends removal around one year post-implantation. FITBONE removal timing is determined by your surgeon based on bone healing.

Is FITBONE available in the United States? Yes, increasingly so. The Fitbone Transport and Lengthening System received FDA 510(k) clearance in 2024, and additional Fitbone systems have launched commercially in the US more recently.

Which device is used more often for cosmetic height lengthening? Precice has historically been more commonly used for this purpose in the US due to its longer FDA-approved history, though this is evolving as FITBONE gains wider US availability.

Do I need an MRI restriction with either device? Possibly. MRI compatibility depends on the specific device model and generation. Always inform your radiologist about any implanted lengthening nail before an MRI.

Key Takeaways

• FITBONE uses electromagnetic induction; Precice uses a magnetic motor system

• Precice has a longer FDA-approval history in the US; FITBONE is expanding US availability since 2024

• Pacemaker patients should discuss magnetic interference risks specifically around Precice

• Neither device is universally superior; the right choice depends on your individual case

• Both carry general risks common to intramedullary lengthening, including delayed healing or angular deformity

• Strong clinical evidence exists for both systems, though direct head-to-head comparative studies remain limited

Final Thoughts

The FITBONE internal nail vs Precice nail decision isn't about picking a "winner." Both are sophisticated, well-studied systems that have moved limb lengthening surgery far beyond the external frames of the past.

What matters most is finding a surgical team experienced with whichever system fits your specific anatomy, medical history, and goals. If you're exploring limb lengthening surgery, bring your questions about both systems to your consultation, and ask your surgeon directly which device they recommend for your case and why.

This article is for general educational purposes and isn't a substitute for personalized medical advice. Please consult a qualified orthopedic surgeon to discuss which limb lengthening option is appropriate for you.