09 January 2024Limb Lengthening Surgery

Recently, there have been advances in limb lengthening surgeries that help people become taller. Two popular methods are the Combined (LON) and Precice 2. They use different techniques to help people increase their height. The LON method combines internal devices (like a nail inside the bone) and external devices (like a fixator outside the body), while Precice 2 uses only internal devices. We’ll discuss the main features, pros, and cons of both LON and Precice 2 methods. You can reach all the details about differences between LON and Precice 2 from our article.

If you’re thinking about getting surgery to become taller and are researching methods, you can check out our other articles. This type of surgery has become more common in recent years, but it’s a big decision. It’s a serious operation, and recovery can be longer and harder than other surgeries. It’s really important to talk to a specialist doctor and get all the necessary tests to see if this surgery is right for you.

What is the Combined (LON) Technique?

Differences between LON and Precice 2? - LON MethodThe LON (Lengthening Over Nails) method is a technique used in leg-lengthening surgeries. This approach involves using both an internal device, known as an intramedullary nail, and an external device, called an external fixator, simultaneously. Although the external fixator, which is attached to the skin from the outside, may result in some discomfort and aesthetic concerns for the patient, the LON method is highly effective in increasing leg length. A key advantage of this method is that it allows patients to walk with support, even with the external fixator in place. Additionally, it is more cost-effective compared to solely internal methods like the Precice system. The process of applying the LON method can be outlined as follows:

  1. Osteotomy Procedure: Initially, a surgical procedure known as osteotomy is performed, involving the cutting of the bone at the desired level in the leg.
  2. Intramedullary Nail Insertion: During the bone lengthening process, an intramedullary nail is placed inside the bone cavity. This acts as an internal stabilizer, maintaining the alignment and stability of the bone segments.
  3. External Fixator Application: Alongside, an external fixator is installed outside the skin. This fixator, attached to the bones, allows for controlled lengthening of the bone.
  4. Bone Lengthening: Post-surgery, the bone is gradually separated at a rate of about 1 millimeter per day, as per the device’s settings. The body responds by generating new bone tissue in this gap, leading to an increase in leg length.
  5. Consolidation Phase: Once the desired leg length is achieved, the lengthening phase ends. The focus then shifts to the consolidation or hardening phase, where the new bone strengthens. During this time, patients gradually start to walk, bearing weight on the external fixator.
  6. Fixator Removal and Rehabilitation: Approximately 2.5 to 3 months after the surgery, the external fixator is removed. Patients continue to walk with support for another 2 to 3 months.
  7. Full Mobility: Walking unaided typically starts around 5 to 6 months following the surgery date.

What is Precice 2?

Precice 2 MethodPrecice 2 is an advanced, fully internal device used for leg lengthening surgeries. Its standout feature is the ability to control the lengthening process internally using a magnetic remote control, eliminating the need for any external devices on the skin. This method is somewhat more costly compared to the LON method due to the technology involved. A major reason patients opt for the Precice method is the absence of an external fixator on the leg, unlike in the LON method. This means that the critical period for dressing and maintaining hygiene is primarily the first 15 days post-surgery. After this period, the dressing process is completed, significantly reducing hygiene-related concerns. The application of Precice 2 can be summarized as follows:

  1. Surgical Insertion of Precice 2 Nail: While the patient is under general anesthesia, the Precice 2 nail is inserted into the bone canal. This is done through a minimally invasive procedure on either the femur or tibia.
  2. Activation of the Extension Rod: Inside the device is an extendable rod, which is activated using a magnetic remote control. This technology enables the bone to be lengthened by about 1 millimeter per day.
  3. Initiation of Bone Lengthening: A few days post-surgery, under medical supervision, the daily bone lengthening process commences. The bone is extended by approximately 1 millimeter daily until it reaches the targeted length.
  4. Completion and Healing Phase: Once the desired length is achieved, the lengthening phase ends. The focus then shifts to the healing phase, where the newly formed bone tissue undergoes hardening and maturation. The goal during this phase is for the bones to fully heal and become robust enough to support the patient’s weight.
  5. Post-healing Considerations for the Device: After the bones have completely healed, the extension device (nail) may either remain inside the body or be removed if deemed necessary.

Combined/LON and Precice Comparison: 

LON and Precice 2 are commonly utilized techniques in leg lengthening surgeries. Patients often express curiosity about the distinctions between these two methods. The differences between LON and Precice 2 can be clearly understood by examining the comparison table provided below.

Features LON Precice 2
Walking during lengthening Supported walking is possible Walking not possible except for basic needs in first 2-3 months
Appearance Fixator present No fixator, internal device (internal nail + control)
Unassisted Walking 5-6 months 6-7 months
Pain Pain related to fixator possible Less pain observed compared to other methods
Full Recovery 9-12 months 9-12 months
Maximum Extension Femur 6-8 / Tibia 5-7 Femur 6-8 / Tibia 5-7
Wound Care Regular dressing Wound closes after the first 2-3 weeks

Individuals contemplating leg lengthening surgery should thoroughly understand the LON and Precice 2 methods, as this knowledge is vital for making an informed choice. Each technique has its benefits and drawbacks, and a well-informed decision greatly influences the recovery process. Before deciding on the surgery, patients need to successfully complete a series of medical evaluations. This includes comprehensive blood tests, X-ray imaging, a general health assessment, and specific evaluations for bone health. Your doctor will provide detailed information about every aspect of the surgery. If you’re deemed suitable for the operation, the preparation phase will be organized. It’s crucial to remember that leg lengthening is a significant surgical procedure, and every step should be approached with the utmost care. In the video linked below, you’ll find an interview with a patient who has undergone this surgery, offering valuable insights from their experience. For more patient interviews about the surgical process, visit our YouTube channel, and for any other queries, feel free to contact to our patient representatives.

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