Lengthening Over a Nail (LON) is relatively new technique that combines external fixator distraction osteosynthesis with the convenience of intramedullary nail.
The Lon method, also known as external fixator combined with intramedullary nail, is a holding system attached by the skin. This method is used for broken bones and lengthening surgery.
The extension is done with the external fixator, the patient extends with a special screw every day by 1 mm to – 1.5 mm every 6 hours (4×6 hours), with the screw on the outside of the external fixator by 0.25 mm – to 0 .5 mm, so that at the end of the day 1 to 1.5 mm can be reached.
For example, with an 8 CM target extension (1mm per day extension), the patient is finished with the complete extension in 80 days.
The external fixators are removed with a small operation and replaced with an intramedullary nail.
The external fixator is attached to the bone through the skin. The intramedullary nail (intramedullary screws) is inserted on the femur either through a small skin incision above the hip or below the kneecap. To extend the lower leg, the intramedullary nail is also inserted below the kneecap.
With the external fixator, the thigh and lower leg bones are gently lengthened.
The surgery lasts on average between 3 to 5 hours under general anesthesia.
Every 6 hours (4×6 hours) the external fixator is turned by 0.25 mm – to 0.5 mm with the screw on the outside so that at the end of the day it reaches 1 to 1.5 mm.
• Wound infection
• Limited choice of clothes
• Restricted sleeping position
• Care of the wounds and pins during the extension
• Removal of the intramedullary nail after 100% healing
• Anesthesia incidents
• Bleeding during or after surgery
• Wound infections
8 months after the external fixation was removed, David can run, jump and much more normally again.(9.8 cm was lengthened on the thigh (femur) with the Lon method)