Limb Lengthening by LON (Lengthening Over Nail) Methodology

How does Limb Lengthening work? – The “LON” Methodology

LON” stands for “Lengthening over Nail”, whereby limb lengthening is achieved, by a combination of two devices, an internal and external device. Limb Lengthening is achieved with the help of an intramedullary nail, surgically embedded into the bone of the patient and externally attached with a fixator for the lengthening process. The intramedullary nail internally stabilizes the patient’s bone, while the lengthening process is realized with the help of an external fixator.

This “LON” methodology, has been the highly preferred by our patients, for simple reasons. Firstly, the system has high reliability, in comparison to classical external fixator methodologies. Secondly, the recovery times are much shorter; and mostly importantly, reasonable costs, in comparison to other latest systems e.g. PRECISE or STRYDE.

What is an Intramedullary Nail?

An Intramedullary Nail or Rod, is generally a metal rod, surgically embedded into the cavity of the bone; it has long been used to treat fractures of the longer bones in the human body. Gerhard Küntscher was accredited for its first application 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 enabled the patients to return to activity within a matter of weeks, as the load of the bone is a shared with the nail, rather than just supporting the bone, as in an external fixator system.

How does this method work?

During the 1st stage of the surgery, an intramedullary nail is inserted 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 preventing 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 which only involved the use of an external fixator. Even today, this methodology is used worldwide by most limb lengthening surgeons.

Limb lengthening by LON method
Limb lengthening by LON method

What are the advantages of LON method?

  • The greatest advantage of the LON method is that the duration of the whole process is reduced, in comparison, to the classical methods, thereby vastly increasing the comfort of the patient and achieving positive results in much shorter periods of time.
  • This positive outlook, generally, reflects more positively to patient psychology due to the fact of the quick removal of the devices.
  • You don’t need to use a wheelchair for the first months like with a motorized nail. Patients usually begin to walk using support from the second day.

What are the disadvantages of LON method?

  • The duration of the surgical operation is longer in comparison to classical surgeries.
  • The experience of the surgeon is key in determining positive outcomes, thus plays a more significant role.
  • Generally, prices and costs are a little higher more 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 Holy-Fix) 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 erased with the help of a simple plastic surgery.

When do I return to my daily life after surgery?

You can get rid of the device in about 2 to 3 months, and overall recovery time lasts around 4 to 5 months; thereby enabling you to return to your normal life within 6 to 7 months. Most importantly, it is varied from patient to patient, as many factors determine the outcome, thus generally dependent upon the patient’s muscles, nerve structure and flexibility of their leg. Irrespectively, recovery times are significantly reduced if patients keep up with physiotherapy and continue the prescribed exercises, in a routinely fashion.

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 procedure. 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.

How much limb lengthening surgery costs with LON method?

While this system is much more expensive than “Holy-Fix” methodology, it is much cheaper than automated and internal only intramedullary nail (PRECISE) 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: (€) 24,000 Euros. (May 2019).

Please note: For a double surgery, first on the Femur 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, (€) 24,000 Euros multiplied by 2 surgeries: (€) 48,000 Euros (May 2019).

Furthermore, for a complete 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 all transportation to the hotels & hospitals
  • Accommodation in a 5-star hotel (1 to 3 days)
  • An English-speaking caretaker who will assist our patients 24/7
  • Complimentary Istanbul tour, including historical and touristic visits, boat tours and meals in our famous Turkish restaurants
  • All necessary medical examinations and tests before the surgical operation
  • 5 to 7 days of hospitalization
  • Physiotherapist’s assistance and all medications are covered, during the patient’s hospitalization
  • Walker, crutches & wheelchair for support & assisted movement (Post-Op)
  • Transportation to the airport upon departure
  • FREE consultation with doctors and consultants whenever the patient’s needs, even after lengthening process has been completed

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

  • All hospital charges relating to 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).

Summer Offer
Get a free voucher up to 1000 euros on Physiotherapy if you opt for any method of Limb Lengthening Surgery until the end of September

* If you will stay in Istanbul during 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 in relation to the procedures, medical teams, prices and any available discounts.

Our patients who choose the LON methodology:

 

Hasan from New Zealand: A Limb Lengthening Journey

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