LENGTHENING OVER NAIL
During the 1st stage of the surgery, an intramedullary nail is inserted into the bone and an external fixator device is attached to the leg from outside
What is the Combined (LON) System Method?
With the combined method, in bone and lengthening surgery, closed nails and a fixator system that provides extension from the outside are applied together. The aim of this system is to get rid of the fixators early thanks to the nails (Intramodular Nail) placed in the cavity inside the bone and to provide a more anatomical elongation without slipping in the bone through a more stable system. This method provides a distinct advantage because it provides a more affordable cost than the closed method, it is one of the most common methods and can carry full loads.
The ‘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.
• 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.
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.
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 on patient psychology.
• You don’t need a motorized nail. Patients usually begin to walk.
How many scars would remain on my leg, after the lengthening process is complete?
It is equivalent to the conventional methods in terms of postoperative scars. 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 the operation. The doctor gives necessary instructions on how to use a special key to turn to screws in order to lengthen bones 1 mm / day. 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.
What is the maximum recommended amount of lengthening?
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.
Limb lengthening surgery costs with the LON method?
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(€)17,678 Euros.
Please note:For adouble 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, (€) 17,678 Euros multiplied by 2 surgeries: (€) 35,356 Euros.
Limb Lengthening For Limb Length Discrepancy Correction (Non-Cosmetic) Singular bone, either Femur or Tibia;with LON Method is (€) 8,500
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
• 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).