If you are considering limb lengthening surgery, you have likely reached the same decision point: “What’s the difference between the LON method and the PRECICE method?” Both techniques are well-established worldwide and deliver reliable outcomes. However, there are clear distinctions in terms of cost, comfort, recovery process, and device design.
So which method is better for you: LON or PRECICE? The answer largely depends on your personal priorities, medical suitability, and aesthetic expectations. At the same time, important technical differences also influence this decision.
Key Differences
LON Method: Combines an internal intramedullary nail with an external fixator attached to the leg. Daily adjustments on the external device gradually lengthen the bone.
PRECICE Method: Uses a fully internal magnetic nail. Lengthening is performed at home using an External Remote Controller (ERC) device that activates the nail.
This primary difference shapes the entire patient experience:
Presence of an external fixator (LON) → lower cost but more discomfort and higher risk of visible scarring.
Fully internal system (PRECICE) → higher comfort and minimal scarring, but significantly higher cost and limited weight-bearing capacity.
📌 In conclusion, the choice between LON vs PRECICE should be made after a thorough consultation with your orthopedic surgeon, taking into account your budget, comfort tolerance, recovery expectations, scar sensitivity, and weight-bearing needs.
LON (Lengthening Over Nail)
How the LON Method Works
During surgery, an intramedullary nail is inserted inside the bone and a temporary external fixator is attached to the leg. After surgery, lengthening begins; the bone is extended at a rate of about 1 mm per day by turning the screws on the external device. This equates to 1 cm every 10 days, or about 7 cm in 70 days. This gradual process, known as distraction osteogenesis, allows the body to fill the gap with new bone tissue, while muscles and nerves safely adapt.
External Fixators & Recovery
The LON method is designed to minimize the time spent with external fixators. The frame typically remains for 2–3 months, after which it is removed; however, the internal nail continues to stabilize the bone throughout the consolidation period. Compared with traditional systems such as Ilizarov or Holyfix, the shorter frame duration reduces the risk of pin-site infections and enables an earlier return to mobility.
The pins and rods of the external fixator, together with the internal nail, keep the bone stable and ensure that the lengthening process remains controlled, precise, and safe until the planned height is achieved.
PRECICE Method (Internal Magnetic Lengthening 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 performed at home using an External Remote Controller (ERC), which activates a magnet inside the nail to extend the bone by approximately 1 mm per day (1 cm every 10 days), as directed by your surgeon.
Lengthening with the PRECICE Method
The gradual and controlled distraction (distraction osteogenesis) ensures proper alignment and stability. This approach usually means simpler wound care, smaller incisions, and helps soft tissues (muscles, tendons, nerves) adapt safely to the new length.
With PRECICE 2 technology, the magnetically controlled system allows patients to make precise, at-home adjustments under close medical supervision. However, weight-bearing restrictions must be carefully observed, and a structured physiotherapy program is essential throughout the lengthening and consolidation phases. Physiotherapy remains a critical factor in reducing discomfort, maintaining mobility, and achieving successful outcomes.
LON VE PRECICE 2
Although the LON (Lengthening Over Nail) method may feel less comfortable at first due to the temporary use of external fixators, it usually allows for earlier and even immediate weight-bearing, depending on the surgeon’s protocol. This early functional loading can stimulate callus formation and promote faster bone consolidation in many cases. The anatomic intramedullary nails used in LON — designed with advanced, stability-focused features by our surgeon Assoc. Prof. Dr. Yunus ÖÇ — work in combination with the external fixator to maintain proper alignment and encourage reliable bone healing. As a result, patients often experience shorter fixator times and a more efficient overall recovery. The rate of bone healing is generally faster with LON, since the magnetic nails used in the PRECICE method are less compatible with bone biology.
One major advantage of LON is its practicality: most mechanical or alignment issues can be corrected externally through simple fixator adjustments, avoiding the need for an additional surgery. By contrast, problems with the PRECICE system usually require surgical intervention or nail replacement, which adds extra cost, operating time, and downtime for the patient.
The PRECICE 2 system, while advanced and more comfortable because it eliminates external fixators, has a significant limitation in weight-bearing capacity. This means the nails may not always provide sufficient support for the bones throughout the entire lengthening phase. LON, despite the initial inconvenience of external fixators, offers much greater durability and strength. The external devices used in this method stabilize the bones effectively, enable immediate weight-bearing, and substantially reduce the risk of mechanical complications.
In conclusion, both the LON and PRECICE methods come with their own advantages and drawbacks. The final decision should always be made in consultation with your orthopedic surgeon after a thorough imaging review and clinical evaluation. Ultimately, your choice should also reflect your personal priorities and expectations — such as your comfort tolerance, recovery timeline, scar concerns, and weight-bearing needs.