Limb Lengthening surgery by LON Method

“LON” stands for “lengthening over nails“. An external fixator device, used in Ilizarov or Holyfix methods, is  used in LON method as well. The main difference is, in LON method, external devices are combined with internal nails. The presence of internal nails provide an important advantage: patients get rid of external fixators earlier, compared to fully external Holyfix and Ilizarov methods. External devices are removed after approx. 3-4 months since surgery. The intramedullary nails stay inside the bones till full consolidation and recovery. After approx. 1-1.5 years, when patient’s bones have fully strengthened, the internal nails can also be removed.

limb lengthening surgery story holyfix-lon
Holyfix and LON limb lengthening surgery methods compared

This “LON” methodology has been highly preferred by our patients for simple reasons. 

  • high reliability, in comparison to classical external methods. Intramedullary nails add more stabilization to the bone.
  • earlier removal of external devices, which allows earlier return to regular daily life activities. To compare, in Holyfix method, patients have to walk, sleep and live with external devices for 9-12 months or more.
  • most importantly, reasonable costs, in comparison to other latest systems such as PRECICE or STRYDE.

For the reasons listed above, around 70-80% of our patients choose LON method.

 

What is an Intramedullary Nail?

An Intramedullary Nail or Rod, is generally a metal rod, surgically embedded into the cavity of the bone during a Limb Lengthening Surgery by LON Methodology. In the past, this technique has been used to treat fractures of the long bones in the human body. Gerhard Kuntscher was born in 1939, to treat soldiers, returning from World War 2 with femur fractures; treatment for which, at that time, was limited to traction or plaster; both systems which required long periods of inactivity. This invention has enabled the patients to return to the activity within a week, as well as to the bone.

How does this method work?

During the 1st stage of Limb Lengthening Surgery by LON Methodology, an intramedullary nail is attached and embedded into the bone and an external fixator device is attached to the leg from the outside. Soon after, the lengthening period begins and the intramedullary nail helps in any angular deformity, during this phase. Once the lengthening phase has been completed, the external fixator can be removed with the completion of the internal fixation (screw insertion). This method was a groundbreaking development compared to the original methodology. Even today, this methodology is used worldwide by most limb lengthening surgeons.

Limb Lengthening Surgery by LON Methodology
Limb lengthening by LON method

What are the advantages of the LON method?

  • The greatest advantage of the LON method is that the duration of the process is reduced, in comparison, to the classical methods, and the results of the patient.
  • This positive outlook, generally, reflects more positively to patient psychology.
  • You don’t need a motorized nail. Patients usually begin to walk.

What are the disadvantages of the LON method?

  • The duration of the surgical operation is longer in comparison to classical surgeries.
  • Generally, prices and costs are higher than classical methods, because of the usage of intramedullary nails.

How many scars would remain on my leg, after the lengthening process is complete?

It is equivalent to the conventional methods ( Ilizarov or Holyfix ) in terms of postoperative scars. While some people may find the scars disturbing, others may find them too insignificant to notice and worry about. Nevertheless, those patients who would like to get rid of scars can easily have them removed with a minor plastic surgery operation.

Step by step guide to LON method

-lengthening begins after 4-5 days since operation. Doctor gives necessary instructions on how to use a special key to turn to screws in order to lengthen bones 1 mm/day. Additionally, bandage change and pin site care instructions are also given. These are important for avoiding infection. After doing the first session of lengthening at the hospital, patients are released.
-lengthening takes around 2-3 months (usually 1 mm/day. For example, 6 cm takes 2 months, and 7 cm takes 70 days) depending on lengthened amount
-another 2-4 weeks pass before slight consolidation is visible on x-rays. Then external fixators are removed.
– 1-1.5 yrs (or less, if bone consolidation is fast) after external fixators are removed, intramedullary nails can also be removed because at this time the bone is fully consolidated
-it is possible to walk during the entire period of fixation, although with some difficulties and limitations. After externals are removed, walking becomes a lot easier and patients are able to walk normally and live their daily life with the exception of doing sports (this will be possible after full consolidation)

Here you can see one of our LON patients walking on the next day after surgery, with the help of a walker device:

 

What is the maximum recommended amount of lengthening?

According to the Surgeon’s guidelines and recommendations, lengthening varies from 6 to 8 cm in a single Limb Lengthening Surgery by LON Methodology. Those who wish to grow even taller (for example, 12 to 14 cm) can achieve this by lengthening both lower and upper legs (lengthening in both the femur and tibia bones). The flexibility of the patient’s legs is fundamental in this lengthening process. The more flexible your legs are, the more comfortable you will be during this lengthening period.

Limb lengthening surgery costs with the LON method?

While this system is much more expensive than the “Holyfix” methodology, it is much cheaper than an automated and internal-only intramedullary nail (PRECICE) methodology.

At the moment, the cost for a single bilateral (Both Legs) surgery, either on the “femoral” or “Tibial” bones for leg lengthening, with ” LON ” Methodology is currently priced at around:  19,000(€) 17,000 Euros. (Please note that the listed discounted prices are valid till the end of global COVID-19 pandemy, unless otherwise mentioned.) .

Please note: For a double surgery, first on the femoral bones and later on the tibia bones or vice versa ( with a 6 months consolidation period between both the surgeries ); the price will be calculated as two separate surgeries. Thus, (€) 17,000 Euros multiplied by 2 surgeries: (€) 34,000 Euros.

Limb Lengthening For Limb Length Discrepancy Correction (Non-Cosmetic) Singular bone, either Femur or Tibia; with LON Method is (€) 9,000

Furthermore, for a completely healthy and smooth limb lengthening experience, we provide the following facilities, which are included in the total price:

  • Meeting and greeting our patients at the airports, including transportation to the hotel & hospital
  • Accommodation in a 5-star hotel (1 day)
  • An English-speaking caretaker who will assist our patients 24/7 during hospital stay
  • Complimentary Istanbul tour, including historical and touristic visits, boat tour and meals in our famous Turkish restaurants
  • All necessary medical examinations and tests before the surgical operation
  • 5 days of hospitalization
  • Physiotherapist’s assistance and all medications are covered, during the patient’s hospitalization
  • Walker, crutches & wheelchair 
  • Transportation to the airport upon departure
  • FREE consultation with doctors and consultants throughout the whole procedure

The above-mentioned price also includes the following costs, in addition to the surgery itself

  • All hospital charges associated with the operating room and recovery room.
  • Surgeon’s fees.
  • Anesthesiologist’s fees.
  • Surgical assistant’s fees.
  • Hospitalization fees (Internal medicine doctors will be available during the entire hospitalization period).

Get a free voucher up to 1000 euros on Physiotherapy!

* If you will stay in Istanbul during the distraction phase after the surgery you can get free physiotherapy service once every two
days during 2 months

* If you will leave Turkey after the surgery you can get a voucher up to 1000 euros for physiotherapy in your home country.
Furthermore, you can contact our patient consultants, at your convenience, for a detailed discussion regarding the procedures and any information that you may require concerning the procedures, medical teams, prices, and any available discounts.

Our patients who choose the LON methodology:

 

Hasan from New Zealand: A Limb Lengthening Journey

Jason from UK: LON leg lengthening in Turkey

Jeraldo from Brazil: A journey of limb lengthening in Turkey

Leave your number and we will contact you


 
Comments
    • Dear Daniel,

      First of all, we would like to thank you for your kind comment and interest in limb lengthening surgery. Now, with the LON method, sir there will be an external fixator attached to your leg limbs, till the time that bone consolidation or healing takes place; in about 4 to 5 months.

      Although in the last months, before the fixators will be removed from your limbs, you will be able to walk; but we do not recommend you to drive. This is because of driving safety, although you might be able to drive; but having the fixator on your legs may cause difficulty in emergency situations while driving; hence can be a dangerous driving hazard.

      However, one the fixators are removed, you can return to driving, fully and responsibly; in about 4 to 5 months after the surgery.

      Thank you for contacting us; for more information and questions contact us directly at support@wannbetaller.com

      Wannabetaller Team

      • The external fixators are removed after the lengthening period right? So once lengthening is done e.g 2 months (6 cm). After that it’s possible to drive? Or after the fixators left on after the lengthening period aswell?

        • Thanks for your comment. Doing certain physical activities, including driving, highly depends on the patient. There are those who are able to walk more easily, and even drive a car in the first month or so. While others have a hard time when walking even after lengthening is over. It significantly depends on patient’s efforts for recovery, physiotherapy and individual exercises.
          As for device removal in LON method, usually after lengthening is over, doctor waits for additional 2-4 weeks for some hint of bone consolidation, and then the external fixators can be removed.
          If you have more questions about LON or any other surgery method, feel free to contact us via WhatsApp: +90 533 193 65 00 or support@wannabetaller.com.

  • hello, I am a 26-year-old university student, female. mt height has been an issue all my life, i am 5ft and 4 inches. i wanted to know more about lon method and will i be able to return to classes in 3 months after the surgery.

    • Dear Claire,

      First of all, we would like to thank you for your kind comment and interest in limb lengthening surgery. Now, I will try to explain the LON Method; which is also known as the combination method; whereby both an intramedullary nail for support and strength is used alongside an external fixator for distraction purposes. The advantage of this method is that its recovery time is much shorter to older methods such as Holyfix o Ilizarov; plus the cost of the procedure is relatively is within economic ranges than in comparison to Precice systems.

      Now with Lon Method, during the distraction phase, you can possibly move around but the fixator would be attached to your legs; if that does not discomfort you; then its completely fine to return to your classes and movement with the assistance of crutches. In all reality, you will finally be able to move about freely; after the external fixators are removed around the 4th to 5th-month post-surgery.

      Thank you for contacting us; for more information and questions contact us directly at support@wannbetaller.com

      Abdul Rehman Yasin
      Wannabetaller Team

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