Exploring the Lengthening Over Nail (LON) Method

In the realm of limb lengthening surgeries, innovation continues to shape the landscape, offering patients enhanced comfort, shorter recovery times, and ultimately, improved outcomes. One such advancement gaining traction is the Lengthening Over Nail (LON) method, also known as the combined method, which revolutionizes traditional approaches by significantly reducing external fixation duration.

 

The Evolution of Limb Lengthening

Traditional methods like the Ilizarov and Holyfix systems necessitate prolonged periods of external fixation, resulting in extended recovery times and potential discomfort for patients. However, the LON method introduces a game-changing advantage: a shorter duration of external fixation, typically around 2 to 3 months, compared to the 9 to 12 months required by conventional methods.

 

Understanding the LON Method

At the core of the LON method are two key components: the external fixator and the intramedullary nail.

Monolateral 

Ilizarov

External Fixator:

Serving as an external scaffold, the fixator stabilizes the bone during the lengthening process. This sturdy metal frame, secured with pins, provides essential support throughout the treatment period.

Intramedullary Nail:

The internal fixation component, made of biocompatible titanium alloy, is surgically inserted into the bone cavity. This nail, customized to fit each patient’s unique anatomy, enhances stability and promotes accelerated bone formation.

Initial Surgery:

The journey begins with the insertion of the intramedullary nail and the attachment of the external fixator. Patients gradually lengthen the bone by turning screws at a prescribed rate, typically 1 mm per day.

External Fixator Removal:

Once the desired height is achieved, the intramedullary nail is secured with screws to maintain the length. Subsequently, the external fixator is removed, allowing patients to transition to the next phase of their recovery.

Nail Removal:

Following full bone consolidation, patients may opt to have the intramedullary nail removed through a relatively simple procedure, typically after one to one and a half years.

Advantages and Considerations

Early External Fixator Removal:

The LON method enables the removal of external fixation devices much earlier than traditional methods, facilitating a quicker return to normal activities.

Cost-Effectiveness:

Compared to internal methods like Precice and Stryde, the LON method offers a more budget-friendly option for patients seeking limb lengthening procedures.

Infection Risk:

Proper wound care and dressing changes are crucial to minimize the risk of infection associated with external fixators.

Comfort Considerations:

Patients should be prepared for the presence of external fixators during the lengthening process, which may impact their comfort compared to internal methods.

Conclusion

The Lengthening Over Nail (LON) method stands out in the realm of limb lengthening for its streamlined recovery and cost-efficiency. This innovative approach marries practicality with advanced technology, enabling patients to achieve their desired physical enhancements effectively and comfortably.

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