Limb Lengthening by LON Method
The LON limb lengthening method uses the external fixator to lengthen gradually.
In the LON method of limb lengthening, the bone’s osteotomy is performed first. Osteotomy is a controlled and delicate incision on the leg; lengthening is done from this part. A rod is then inserted into the bone of the leg. Three screws are installed in the upper part of the bone incision. The external fixator is mounted on the bone from the outside, and the foot and the lengthening are done gradually. At the end of the distraction phase, the screws are installed below the incision, and the external fixator is removed.
Supplementary information about LON method:
There are two main parts to limb lengthening by the LON method. The external part and the internal part. The external part is responsible for increasing bone length. The internal part, which is a nail, is placed inside the bone. The task of nails is to prevent bone reduction.
In LON limb lengthening, an external fixator is installed on the volunteer leg or thigh, and a bar is inserted into the bone. An external fixator does limb lengthening in this method. As with the MTN method of limb lengthening surgery, the candidate can have a 1 mm increase daily.
Suggested to study: limb lengthening surgery by MTN method
In the LON method, which is usually used for people who are overweight, two surgeries are performed. In the first surgery, an internal rod is installed. The rod is attached to the bone at the top of the osteotomy through two or three screws. The bottom of the bar does not screw, although there is room for screwing. The reason is the possibility of increasing bone length.
In the first surgery, after installing the rod, an external fixator device is installed on the limb to increase the length of the bone. The type of this device is different, and it varies in other centers. (Some Holyfix and orthopedic design and Ilizarov test and history of Ilizarov hybrid and microbount in China)
After lengthening is completed, in the second operation, the lower screws of the Nail are also installed so that the bone remains in place and does not fall short again. At this stage, the external fixator device removes. Because before installing the lower screws, it was the external fixator’s task to prevent the bone from falling short.
After installing the screws below the Nail, this task is transferred to the Nail. After opening the external fixator device, a glass is installed on the limb to fully ensure that the bone is fixed and better the volunteer’s ability to walk.
Important points in LON limb lengthening surgery:
- Adherence to individual hygiene and keeping the lengthening place clean are very important in the LON method.
- In some people, sleeplessness or even insomnia occurs for some time, which can be controlled with appropriate medications.
- The amount of pain varies from person to person, but what is certain is that doing stretching exercises can significantly reduce it.
- A pain pump is used the day after the surgery, a special device for the same purpose (pain control). It continuously and slowly injects strong analgesics and causes postoperative pain control.
- The next day, Dr. Motallebizadeh personally visits the volunteer and checks all the necessary item, and the volunteer is allowed to walk. Most people can walk (with a walker, of course) the day after surgery and are discharged from the hospital.
- During the bone lengthening, we should keep in mind that the simultaneous increase of soft tissue length is the volunteer’s duty, which will be possible by performing regular and sufficient stretching exercises and physical therapy.
- After completing the distraction phase by the LON method and reaching the desired height, the external device is removed for more stability and safety until 70% recovery of the bones at the site of the augmentation from the combination of pins and fiberglass in the leg area can be removed outside the operating room.
- By doing special exercise, proper nutrition, and tips expressed by Dr. Motallebizadeh, bone formation can be accelerated. And return to everyday life as soon as possible.
Suggested to study: limb lengthening surgery by LATN method