If you are considering limb lengthening surgery, you have likely come across the same question: “What’s the difference between the LON method and the PRECICE method?” Both techniques are well-established worldwide and are known to deliver safe and reliable results.
However, there are clear differences between them in terms of cost, comfort, recovery process, and device design.
So, which method is the better choice for you — LON or PRECICE? The answer depends on your personal priorities, medical suitability, and aesthetic expectations. At the same time, the technical distinctions between the two methods also play a significant role in guiding this decision.
Key Differences
LON Method
The LON (Lengthening Over Nail) method combines an internal intramedullary nail with an external fixator attached to the leg. By making daily manual adjustments on the external device, the bone is gradually lengthened over time.
PRECICE Method
The PRECICE method uses a fully internal magnetic nail, eliminating the need for external fixators. Lengthening is performed at home using an External Remote Controller (ERC), which activates the nail magnetically and allows for safe, precise daily adjustments.
This key difference defines the overall patient experience:
LON Method (with external fixator): Offers a lower cost, but comes with more discomfort and a higher risk of visible scarring.
PRECICE Method (fully internal system): Provides greater comfort and minimal scarring, but involves a significantly higher cost and has a limited weight-bearing capacity.
📌 Conclusion:
The decision between LON and PRECICE should always be made after a thorough consultation with your orthopedic surgeon, carefully considering factors such as budget, comfort tolerance, recovery expectations, scar sensitivity, and weight-bearing requirements.
LON (Lengthening Over Nail)
How the LON Method Works
During surgery, an intramedullary nail is placed inside the bone, while a temporary external fixator is attached to the leg. After the procedure, the lengthening phase begins: the bone is gradually extended at a rate of approximately 1 mm per day by turning the screws on the external device. This equals about 1 cm every 10 days, or around 7 cm over a 70-day period. This gradual process, called distraction osteogenesis, allows the body to naturally form new bone tissue, while the surrounding muscles, nerves, and blood vessels safely adapt.
External Fixators & Recovery
One of the main advantages of the LON method is that it reduces the amount of time patients must use external fixators. The external frame usually remains in place for 2–3 months, after which it is removed. The internal nail, however, continues to support and stabilize the bone throughout the consolidation period. Compared to older systems such as Ilizarov or Holyfix, this shorter frame duration lowers the risk of pin-site infections and allows patients to regain mobility sooner.
The pins and rods of the external fixator, combined with the stability of the internal nail, keep the bone aligned and ensure the lengthening process is controlled, precise, and safe until the desired height is achieved.
LON (Lengthening Over Nail)
How the PRECICE Method Works
In limb lengthening surgery with the PRECICE method, a titanium intramedullary nail is implanted inside the bone — with no external fixator required. Lengthening is carried out at home using an External Remote Controller (ERC), which activates a magnet inside the nail to gradually extend the bone by about 1 mm per day (or 1 cm every 10 days), according to your surgeon’s instructions.
Lengthening with the PRECICE Method
This gradual and controlled process, known as distraction osteogenesis, ensures proper alignment and stability of the bone. The PRECICE system also offers several advantages, including smaller incisions, simpler wound care, and safer adaptation of soft tissues such as muscles, tendons, and nerves to the newly gained length.
With PRECICE 2 technology, the magnetically controlled system enables patients to make precise adjustments at home, always under close medical supervision. However, it is important to note that weight-bearing restrictions must be strictly followed to avoid damaging the nail. Throughout both the lengthening and consolidation phases, a structured physiotherapy program is essential to minimize discomfort, preserve mobility, and ensure the best possible outcome.
LON ve PRECICE 2
Although the LON (Lengthening Over Nail) method may feel less comfortable initially due to the temporary use of external fixators, it generally allows for earlier — and in some cases immediate — weight-bearing, depending on the surgeon’s protocol. This early functional loading often stimulates callus formation and promotes faster bone consolidation. The anatomic intramedullary nails used in the LON method, designed with advanced stability-focused features by Assoc. Prof. Dr. Yunus ÖÇ, work together with the external fixator to maintain alignment and support reliable bone healing. As a result, patients usually experience shorter fixator times and a more efficient recovery overall. Bone healing is often faster with LON, as the magnetic nails used in the PRECICE system are generally considered less biologically compatible.
A major advantage of the LON technique is its practicality. Most mechanical or alignment issues can be corrected externally through simple adjustments to the fixator, avoiding the need for additional surgery. By contrast, complications with the PRECICE system often require surgical intervention or even nail replacement, which can increase costs, extend operating time, and prolong recovery.
The PRECICE 2 system, while technologically advanced and more comfortable since it eliminates external fixators, has a significant limitation: its restricted weight-bearing capacity. This means the nails may not always provide sufficient support throughout the entire lengthening process. In comparison, the LON method — despite the inconvenience of external fixators — offers greater durability and strength. Its external devices stabilize the bones effectively, enable early weight-bearing, and help reduce the risk of mechanical complications.
📌 In conclusion, both the LON and PRECICE methods have their own distinct advantages and limitations. The final decision should always be made in consultation with an orthopedic surgeon, based on a detailed clinical evaluation and imaging review. Ultimately, the choice should also align with your personal priorities — such as comfort level, recovery expectations, scar concerns, and weight-bearing requirements.
