Limb Lengthening surgery by LON Method

“LON” stands for ” lengthening over nails “, which literally means that the bones are distracted or lengthened with an internal nail; however the bones are lengthened using a mono-lateral type external fixator device; similar to the one used in Holyfix method. The  main difference between the LON method and Holyfix is ​​the presence of the internal intramedullary nails over which the bones are lengthened over. This provides some important advantages over other fully external methods like Holyfix or Illizarov; that the patients are enabled to have the external fixators removed much earlier than with fully external methods. Usually, with LON, external devices can be removed approx. 3-4 months, after the surgery. The intramedullary nails stay inside the bone cavity until, the bones fully consolidate, heal, and recovery; which can usually happen, approximately, after 1-1.5 years of the surgery. After which the patient’s bones should have fully strengthened, the internal nails can also be removed by a minor surgical operation.

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

This “LON” methodology is highly preferred by our patients for these simple reasons. 

  • High reliability, in comparison to classical external methods. Intramedullary nails add more stabilization to the bone.
  • Early removal of external devices , which allows earlier return to regular daily life activities. To compare, in the 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 the LON method.

 

What is an Intramedullary Nail?

An Intramedullary Nail or Rod, is generally a metallic nail type rod device which is surgically embedded within the bone cavity, during a Limb Lengthening Surgery by LON Methodology. In the past, this technique had been employed by medical practitioners in order to treat fractures of the long bones in the human body. The medical pioneer, Gerhard Kuntscher, who was born in 1939, had to treat soldiers who were returning from World War 2 with femur fractures. But the treatment available at that time was limited to traction or plaster; both systems required long periods of inactivity and hence prolonged recovery periods. His invention of the intramedullary nail had enabled his patients to return to the activity within a week, as well as having faster bone healing.

 

How does this method work?

Now, the limb lengthening mechanism in LON methodology works with two devices, an internal intramedullary nail that is attached to a mono-lateral type external fixator. During the Limb Lengthening Surgery by LON Methodology, an intramedullary nail is surgically embedded into the bone by the surgeon, and an external fixator device is attached to the intramedullary nail, from the outside of the leg.

Once the LON apparatus is surgically attached to the patient’s legs; soon after 3-5 days of post-surgery hospitalization, the lengthening period begins at the hospital, whereby the external fixator is elongated or distracted by 1 mm per day, allowing the patient’s bone to separate, with the intramedullary nail inside their bones. The biggest advantage of having an intramedullary nail in this method is that it helps in correcting any angular bone deformity, during this lengthening phase, as well. Within 60 to 80 days of lengthening, elongation of the bone is stopped, and we let the bone start to heal between the gaps created; and once there is ample weight-bearing bone consolidation, usually 30 to 45 days after the lengthening has been stopped; the doctors could remove the external fixator devices. This allows for quicker recovery time, in comparison to purely external fixator methods; as after this stage the patient’s bones would generally take around 5-6 months to fully heal. Thus, allowing the whole process to complete in 8 to 9 months; which in reality is as fast as any internal method; this is why LON is one of the most preferred methods of Limb Lengthening surgery by our patients worldwide.

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 the 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?

Lengthening varies, depending on the choice of bone the patients lengthens, the femurs or the tibias, in their Limb Lengthening Surgery by LON Methodology.

Under the Medical Safety and Surgical guidelines and recommendations, with a single limb lengthening surgery, the patients can lengthen up to 3 inches; or to be exact:
1. Femurs (Thighs): 6 – 8 cms OR
2. Tibias (Calf’s): 5 – 7 cms

However, you may even opt to have two limb-lengthening surgeries, with a gap of 6 months between the two surgeries and gain up to 6 inches or 12 – 15 cms. But it must be remembered that the flexibility of the patient’s legs is fundamental in the lengthening process and achieving the max height achievable within the safe limits. The more flexible your legs are, the more comfortable and pain-free, the patients would 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 pandemic, 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

Also, 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 the 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.
Also, 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
  • Hi just wanted to ask if I get a 8cm femur lengthening would I be able to walk properly without any crutches and go to the gym to train (upper body) after the external device is taken out?

    Thanks,
    Brian

    • Dear Sir/Madam,

      Now with external fixator system like the LON method, generally, patients start to walk with crutches after the surgery as there are internal nails to support the weight of the limbs. However, the use of assistance, like crutches is advised until your fixators are removed, around the 3-4 month post-surgery. Once, the fixators are removed, you will be able to walk without much assistance and slowly and gradually regain strength as the bones heal completely by the 9 to 10 months, after the surgery.

      Furthermore, you can go to the gym to work out light upper body exercises,m but make sure that you do not exert any pressure onto the healing bones till they are completely healed by the 10 to 12 month.

      WannaBeTaller Team

    • Dear Brian Sean,

      Now, with any limb lengthening method that you choose, once your bones heal back to normal again, you will be able to walk without crutches and go to the gym to train as well. Now, recovery time is varied according to the method of surgery that the patient chooses. For example, with internal methods like Precice Stryde, you can start to walk in just 4-6 weeks without crutches. Furthermore with the LON method, generally, patients start to walk with crutches after the surgery and the use of assistance, like crutches, is advised until your fixators are removed, around the 3-4 month post-surgery. Once, the fixators are removed, you will be able to walk without much assistance and slowly and gradually regain strength as the bones heal completely by the 9 to 10 months, after the surgery.

      WannaBeTaller Team

  • Hello, if I decide to choose the LON method to lengthening 5cm, will I be able to walk without crutches after the fixators are removed? if not, on average how long do I have to walk around with crutches until my leg can handle my full body weight?

    • Dear Sir/Madam,
      Now with the LON method, generally, patients start to walk with crutches after the surgery as there are internal nails to support the weight of the limbs. However, the use of assistance, like crutches is advised until your fixators are removed, around the 3-4 month post-surgery. Once, the fixators are removed, you will be able to walk without much assistance and slowly and gradually regain strength as the bones heal completely by the 9 to 10 months, after the surgery.

      WannaBeTaller Team

    • 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 [email protected]

      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 [email protected].

  • 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 [email protected]

      Abdul Rehman Yasin
      Wannabetaller Team

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