• Dr. Yuksel Yurttas

Limb Lengthening: Which Method to Choose?


If you've been researching to increase your height with surgery, you've seen many doctors, clinics, and lengthening methods. However, deciding on the right limb lengthening method for you can be confusing. For this reason, we have prepared a comprehensive article that will make it easier for you to decide on the method of limb lengthening surgery. Here are the features, advantages-disadvantages, and differences between advanced methods of limb lengthening.

First of all, limb lengthening procedures are technically similar to each other. The limb lengthening procedure begins with an osteotomy, in which the orthopedic surgeon cuts the bone that needs to be extended. The limb is then stabilized with external and-or internal fixation devices or frames (generally the upper or lower leg).


The recovery process is divided into two phases. First, the bone that has been cut is gradually pulled apart in the first phase to promote distraction osteogenesis or new bone growth at the osteotomy site. Distracting or spreading the gap four times a day, 0.25 mm at a time, for a total of 1 mm per day, promotes the continued growth of new bone tissue. The body continues to produce new bone tissue in the gap between the ends of the bone as it opens up until the desired length of bone is generated.


In the second phase of treatment, the lengthened bone consolidates and heals. The patient gradually puts more weight on the legs and walks without support. Once the bone is fully consolidated and the soft tissues surrounding the bone have adjusted to your new height, you can perform all physical activities.

All limb lengthening methods are based on this proven scientific theory. Therefore, the method you will choose will be how this theory is applied in practice.

There are five limb lengthening methods used by surgeons today. Two of these are external, one is internal-external combined, and the other two are internal methods. Although all these methods are based on the same logic, they offer pretty different treatment processes and patient experiences in practice.


External Methods

1. Ilizarov

2. Holyfix


Ilizarov External Fixation
Ilizarov External Fixation

External methods require the use of external fixation for 9-12 months in addition to the 3-4 month extension period. The long treatment time of external methods causes an uncomfortable lengthening experience for patients. In addition, there is a risk of infection in the pin sites fixed to the bone. Therefore, the pin locations need to be disinfected daily. One of the disadvantages of these methods is that they leave more scars on the legs compared to the combined and internal methods. Although the price of the surgery is affordable, delaying the return to daily life may cause more costs to the patient. Today, these methods are widely used in the treatment of leg curvature, apart from cosmetic leg lengthening.


Advantages: Low cost

Disadvantages: 12 months external fixator usage period, Long treatment period, Infection risk at pin sites, excessive scarring



Internal-External Combined Method

LON Method (Lengthening Over Nails)


LON method
LON Method Leg Lengthening

LON is a method in which an external fixator and an intramedullary nail are used together. The external fixator is used only during the 3-month lengthening period. After the lengthening process is complete, the external fixator is removed with a minor operation and the intramedullary nail remains in the bone marrow until the full bone healing. A few weeks after the device is removed, the patient can return to his home and daily life. In this method, returning to daily life and normal walking takes about 4-5 months in total.



In recent years, the LON method has been preferred by patients due to its short treatment period, shorter return to daily life, comfortable patient experience, and affordable price.


Advantages: 3 months external fixator usage period, low cost, high efficiency, walking during lengthening, comfortable lengthening experience

Disadvantages: Risk of infection at pin sites, moderate scarring


Internal Methods

1. Precice 2.2

2. Precice Stryde


Precice 2.2 and Precice Stryde Nails
Precice 2.2 and Stryde Nails
Precice 2.2

The Precice 2.2 method has revolutionized limb lengthening procedures. In this method, a titanium nail is placed in the bone marrow. Lengthening is done daily with a remote control device used from the outside of the leg. This method leaves very small scars on the leg. Therefore, it is a suitable choice for those with aesthetic concerns. It also offers a comfortable lengthening experience without the risk of infection.



The notable disadvantage is that titanium nails cannot support the full body weight. Therefore, it is not possible to walk and return to daily life during the treatment period.


Advantages: No external fixator usage, no infection risk, comfortable lengthening experience

Disadvantages: Inability to walk during the lengthening period, high cost


Precice Stryde

Precice Stryde is the most advanced and most expensive method of limb lengthening today. It has similar features to Precice 2. However, Stryde nail is made of hardened stainless steel. Therefore, this method allows patients to walk throughout the entire procedure, including the lengthening process. Patients can return to daily life a few weeks after the surgery.


Despite the high demand for Precice Stryde, production was stopped in 2021. As we enter 2022, it still has not started production again.


Advantages: No external fixator usage, no infection risk, comfortable lengthening experience, walking during the lengthening period, low scarring

Disadvantages: High cost


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