Limb Lengthening Surgery with LON Method
Unlike the traditional methods like Ilizarov and Holyfix, the external fixators only stay on the leg for 2 or 3 months with LON method. Thus, patients have the opportunity to have less infection risks and regain their movement skills.
The easiness while applying and being economic makes this method an ideal option for many patients, and patients do not only get rid of the fixators more quickly; but also they get the chance to adapt their daily life in no time.
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Components of the LON method
External Fixators;
This is a strong structure that supports the bone externally in lengthening surgery. This device helps the bones to union correctly by holding the bone still during the lengthening process. The fixator that consists of thick metal sticks is fastened to the bones with special pins, therefore the bones can be lengthened safely and controlled.The device is placed during the surgery and generally stays on the leg for 2-3 months until the desired height goal is reached. Meanwhile the external fixator both protects the balance of the bone and supports the lengthening process to go on healthily.
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Intramedullar Nail;
These are bone-compatible nails that are made of titanium used to support the bone and safely maintain the lengthening process in lengthening surgeries. The size of the nail is determined by the doctor after the x-ray displays are examined and generally have the size of 8,5 mm, 10,7 mm, 11,5 mm or 12,5 mm. Getting placed inside the bone space during surgical process, this nail does not harm or damage the body tissues and does not create any negative reaction thanks to its biocompatible feature.
2 + 1 Surgeries with LON Method
Three surgeries will be done if the LON method is chosen for the limb lengthening;
1. First Surgery; The surgery is conducted under general anesthesia, which means that the patient will be completely asleep during the operation and won’t feel any pain. Before the surgery, the doctor makes a plan according to the requirements and physical characteristics of the patient. During the surgery, leg bones (upper leg/femur or lower leg/tibia) will be carefully cut from the point that is determined. This controlled cutting process makes space for the bone to lengthen later on. Intramedullar nail and external fixator are used for the bone union and correct lengthening. 5th day after the surgery the lengthening process starts. The patients lengthen the bone by 1mm daily by turning the screws. (The screw is turned with a metal key every 6 hours/ 0,25 mm x 4)2. Removal Surgery for External Fixator;
When the desired height goal is reached, in order to preserve this height, the nail inside the bone is implanted with screws. The surgery lasts about 1-2 hours and the patient needs to stay 1 day at the hospital under the doctor’s observation. The intramedullar nail that stays inside the bone keeps supporting until the new bone matures and hardens and helps the lengthened height stay permanent.The video of external fixator extraction of our patient who reached their height goal.
- It generally lasts about 12-15 months after the lengthening surgery in order for the bones to union completely. The nail can be removed at the end of this period if the patient wishes to. After this operation which lasts about 1,5-2 hours, the patient stays under doctor’s observation and then gets discharged from the hospital. It is suggested to use crutches for 2-3 weeks so that the stitches won’t reopen. Some patients may prefer living with the nail since it doesn’t cause any health problems. The doctors do not see any harm in that because the nails are compatible with the bone. You can watch the moment of surgery where the intramedullar nail is removed according to the patient’s request.
What Are the Advantages of the LON Method?
- Quick recovery: The external fixators are removed after about 2-3 months with the LON method. This early removal quickens the recovery process and helps the patients to gather their strength in less time.
- More lengthening: Since the capacity of the device is more than the other methods, it is possible to grow 9-10 cm taller, especially for the young patients.
- Opportunity to walk with support: Throughout the process short distances and basic needs are met by supported walking. It offers a lengthening and recovery process that is more comfortable than staying still without any movement. While the patient has to move with a wheelchair for the most part of the lengthening process with other methods, the LON method offers movement freedom to patients.
- Convenient Cost: The LON method offers a lengthening option which is affordable. While early removal of the external fixators decreases the total cost, it also provides a high quality and economical solution. This advantage makes this method one of the most preferred methods among limb lengthening surgeries.
- Controlled and safe lengthening: With the LON method, since both external fixator and internal nail are used, the bones union correctly and solid. This dual support holds the bone still and minimalizes the risks of wrong union throughout the lengthening process. Due to this control mechanism, a safe limb lengthening process is obtained with LON method.
- A Process that provides psychological support: The LON method which offers freedom of movement and provides a quicker recovery, also has a psychologically relaxing effect. Being able to walk with a support helps patients feel stronger and protect their motivation during the long healing process.
What Are the Disadvantages of the LON Method?
- Being disturbed by the external fixators: In the LON method, the external fixators stay on the legs for a few months after the surgery. This might be disturbing for some patients. Because of the fixators, the sleeping quality may be disturbed since patients have to sleep in one position, there might be restrictions in movements and might need extra care.
- Risk of infection: there is a risk of infection where the external fixators meet the skin and soft tissue. Especially not keeping the area of fixators might lead to infection. In order to decrease this risk, a specialized treatment plan is made.
- Aesthetical concern and Scars: the use of external fixators might leave scars on the legs. Even though the scars fade over time, this might create aesthetical concern for some patients.
- Psychological effect and feeling uncomfortable: living with fixators might be mentally difficult for some patients. In this process, the existence of fixators in daily life might be disturbing and depressing for some patients.
- Shower restriction: with the LON method, since getting the fixators wet might create infection risks, it is not suggested to take showers during the lengthening process. Only way of taking a shower can be without getting the surgical area wet.
- Requirement of Expertness: applying the LON method requires advanced level expertness on orthopedic. Thus, not every orthopedic surgeon can conduct this surgery. Finding an experienced surgeon might be difficult and a surgery made by a doctor who is not capable enough might increase the risk of complication.
Why is the LON method often preferred by our patients?
- Quick recovery: with LON method, the external fixators only stay for 2-3 months, which quickens the recovery process and makes it possible for the patients to regain their strength in less time. It offers a quick chance of going back to work or doing activities like sports.
- Supported Walking Possibility:throughout the lengthening process (2-3 months) patients can walk short distances with support, which makes the process mentally easier.
- Economical and practical solution: the LON method is an ideal option because of the fact that it is affordable, and it is easy to apply.
- Psychological comfort: assisted walking and the chance of getting rid of the fixators in little time both makes the patients feel better and increases their adaptability to the recovery process.
- High Patient Satisfaction: the advantages that the method offers and the easier recovery process keeps the satisfaction of the patients high level.
Because of the reasons listed above, about %80-85 of our patients choose the LON method.
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In the LON method, external fixators are typically removed after 2-3 months. After the devices are removed, your doctor will advise you to gradually stop using support devices (walker, crutches) over a period of 4-6 weeks. The most important factor here is your X-ray results. If your bones heal normally or well, this process may be shortened or extended accordingly. Over the weeks, your mobility will gradually increase, and you will return to your daily life.
One of the most critical factors determining the recovery period is the amount of lengthening. As the lengthening amount increases (for example, every additional 1 cm), the recovery process also becomes longer.
Here is a video of a patient at our center who achieved an 11.5 cm height increase with 2 height lengthening surgeries.
In height lengthening surgery performed using the LON method, pain is usually most intense during the first few days after surgery. However, this pain is managed with appropriate pain relievers and medications, and it gradually decreases over time.
During the first weeks, pain is typically felt due to the healing of the bones and the stretching of muscles. This pain may persist throughout the lengthening process.
During the lengthening phase, patients generally achieve a length increase of about 1 mm per day, which may cause mild to moderate tension and pain. Physiotherapy plays a crucial role in reducing pain and improving mobility during this period.
Pain typically significantly decreases after 4-6 weeks and becomes minimal as bone union is completed.
While methods like Precice allow for a maximum lengthening of 8-8.5 cm, the LON method can achieve 9-10 cm. This is typically achieved in the upper leg (femur). However, this amount depends on the doctor’s approval and the patient’s ability to meet the necessary conditions.
The following are some of the potential risks and complications that may be encountered with the LON method:
- Risk of Infection: Infections may occur at the points where the external fixators come into contact with the skin.
This risk can be minimized through hygienic care and regular dressing changes.
If an infection is not detected and treated early, it could lead to more serious health issues. - Nonunion or Delayed Bone Healing: In some patients, the bone may not heal at the expected rate or may not heal completely.
In such cases, additional treatments like bone grafting or stem cell therapy may be required. - Nerve and Muscle Tension: During the lengthening process, nerves and muscles may become tense.
This can result in nerve compression or muscle pain.
In cases of severe tension, additional procedures like tendon release surgery may be required. - Bending or Fracture of the Nail: The intramedullary nail used during the procedure may bend or break due to excessive load or improper movements.
If this occurs, surgical intervention is usually necessary to correct the problem. - Bone Deformity and Axial Deviation: Misalignment or curvature of the bones can occur.
In such cases, additional corrective surgeries may be required.
While the likelihood of experiencing these complications with the Combined method is low, the risk can be significantly reduced when the surgery is performed by an experienced surgeon and followed by regular medical check-ups.
The cost of height lengthening surgery performed using the LON method typically ranges from $18,000 to $29,000. The price range varies depending on the scope of the treatment, and whether additional services such as accommodation and physical therapy are included.
This price generally covers the following:
- Surgery and a 4-day hospital stay.
- Post-surgery care, including dressing changes and physical therapy.
- A second surgical procedure to remove the external fixators.
- 3 months of accommodation and other health service packages.
A doctor’s consultation is required to determine the exact cost, as the treatment plan and process may differ for each patient.
Conclusion
Limb lengthening surgery with the LON method is a modern and effective option for accelerating the recovery process and enhancing patient comfort. This method allows you to achieve your desired height safely. For detailed information about the entire process and to create a personalized treatment plan, feel free to contact our expert team. You can reach us via email, social media accounts, or our WhatsApp line for any questions or requests. We are happy to guide you in achieving your goals!
Phone & WhatsApp: +90 531 988 3090
Email: support@wannabetaller.com
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