Lengthening Over Nail (LON) – The Combined Method

 Methods using external fixators alone (ilizarov, etc.) require a long waiting period until bone union is completed. This process both reduces patient comfort and prolongs the process of rehabilitation and return to normal life. The combined method aims to shorten this time and increase patient comfort. By combining the nail placed inside the bone with the fixator system, the time the patient spends with the external fixator is shortened. While the fixator must be kept for 9-12 months with completely externally applied systems, this period is reduced to 2-3 months with the combined method. The combined method is superior to traditional lengthening methods, as it provides support both inside and outside the bone, hence it is safer. Combined Method has a lower complication rate because it shortens the process and has many advantages such as ease of application and lower cost.

Combined Limb Lengthening Technique (LON: Lengthening Over Nails)

In the combined method, after the bone is osteotomized, an intramedullary nail inserted into the bone and an external fixator is placed on the side of the leg to lengthen it. Only one end of the nail is attached to the bone with screws. One day after the surgery, you will start walking with two crutches under the supervision of our doctors. It is waited for 5 or 7 days for the formation of soft bone tissue in the fracture area. After the waiting period is completed, our doctors and our professional team will teach you how to lengthen 1 mm per day with an external fixator.

A program will be prepared for you to provide 0.25 mm extension 4 times a day. After the lengthening is completed, it is taken back to the operating room, locking screws are attached to the other end of the intramedullary nail and the external fixator is removed. During this period, you should do the recommended exercises regularly to increase the range of motion of the knee, ankle and hip joint. 

What are the advantages of the Combined (LON) Method?

-According to the Precise method, you don’t need to use a wheelchair in the first months. You start walking using support from day 2.

-Most importantly, it has reasonable cost compared to other latest systems like PRECICE.

-Early removal of the fixator allows you to return to regular daily living activities earlier.

What are the Disadvantages of the Combined Method?

*According to the Precise method, having an outside fixator slightly reduces patient comfort.

*The wound dressing should be changed appropriately to prevent infection. 

%80 of our patients prefer LON method due to the lower cost of the lengthening and allows the patient to walk during the lengthening process. 

With this process achieved at the end of the treatment, we recommend that you prepare for shopping to renew your wardrobe.