Lon Method Limb Lengthening | Reviews - Iranian Surgery We use a minimally invasive method to put the lengthening device and these scars are so small they are not very noticeable. It should be noted that this is not an exhaustive list or summary. Once we reach the desired lengthening height, we remove the external fixators.As soon as we remove the external fixator, you can go back to your country. During the distraction phase, the bone is gradually pulled apart to promote new bone growth. Care of the wounds and pins during the extension The specifics of this phase, including the frequency and amount of distraction, are tailored to each patient and can vary depending on the method used. Bone formation is fast and patients can return to normal activity one or two months sooner than LON patients. All incisions are made minimally and the incision size is less than 2 cm. To compare, in the Holyfix method, patients have to walk, sleep, and live with external devices for 9-12 months or more. He or she will place a series of wooden blocks under the short leg until the hips are level, then measure the blocks to determine the discrepancy. 2017-2021 Iranian Surgery. Insertion of the solid intramedullary nail Hence, since 1959, the hopeful development of such methods was attempted, but clinical practices were minimal. Clinical orthopaedics and related research, 472(12), 38523859. Discover the most effective and affordable options for you. Gains achieved in length can be as much as 10cm/4 inches per bone segment. This method is used for broken bones and lengthening surgery. During the lengthening period, they stay here for approximately 3 months. The LON method is a combined method. It is inserted into the intramedullary canal of the bone and the bone glides over the nail to lengthen. Alternatively. Limb Lengthening Surgery: The Best Surgeons, Methods and Costs Worldwide To extend the lower leg, the intramedullary nail is also inserted below the kneecap. Do you also want to discover the taller you? More frequent physical therapy promotes a better outcome and a shorter recovery period. However, even once the distraction phase has been concluded, it is imperative to continue physical therapy as directed into the consolidation phase. Limb lengthening history, evolution, complications and current concepts. The intramedullary nail (intramedullary screws) is inserted on the femur either through a small skin incision above the hip or below the kneecap. However, the production of this method has been stopped and it is not available worldwide. The Precice 2 method is an internal fixation method that uses a titanium nail. Further, healthy habits, including optimized nutrition, sleep, and increased activity. During the distraction phase, screws on the apparatus are turned, extending the distance between rings and stretching the bones apart slowly. To ensure stability during the recovery process, the surgeon uses a variety of external and internal fixation devices or frames. They may also be referred to as intramedullary nails, intramedullary rods, or telescopic nails. Unilateral External Fixator (Monorail Fixator). The external device can be an Ilizarov fixator, a monolateral (rod-like) fixator, or any other device developed by some doctor anywhere, it is mainly up to the preference of the surgeon who practices limb lengthening. The process of bone healing typically takes 5-6 months, and full recovery, including regaining strength and mobility, takes 9-12 months. Using an internal fixator such as the ISKD, there is generally improved patient comfort and tolerance in comparison to external methods. (2021, February 20). Some studies show that patients with limb length discrepancies are more likely to experience low back pain and are more susceptible to injury. Locking of the proximal part of the intramedullary nail to the bone 19 mays bulvar No:1834510 Esenyurt/stanbulWhatsApp: +905339735289Instagram: @dryukselyurttas Twitter: @dryukselyurttas#limblengthening #leglengthening #heightlengthening You can come back after 1 or 2 years to remove the nails.The cost of the removal is $5,000 and you only need to stay 2-3 days. Since the intramedullary nail has a high load-bearing capacity, the patient can continue to walk with full body weight. Journal of orthopaedic trauma, 26(9), e138e144. The fixator must remain in place through the consolidation phase to support this process and ensure no further damage is sustained. For a more detailed exploration of the limb lengthening process, each of the four phases of the procedure will be explored with more detail. show more. Rehabilitation Center; Methods. It is possible to walk during the entire period of fixation, although with some difficulties and limitations. . This phase is significant to regain mobility and functionality. + Highly reliable and most commonly performed Limb Lengthening method in the world currently. + Most important factor is it's very reasonable cost. For example, with an 8 CM target extension (1mm per day extension), the patient is finished with the complete extension in 80 days. concluded that the PRECICE nail offered patients favorable outcomes compared to the ISKD system or an external Limb Reconstruction System (LRS) [10]. The duration of the surgical operation is longer in comparison to classical surgeries. LON Method, Precice 2.2 Method, Precice STRYDE. With over 500 successful operations, a team of experts, state-of-the-art technology and state-of-the-art hospitals, we are number 1 in our sector in Turkey. Patients who have differences of 3-1/2 to 4 percent of total leg length (about 4 cm or 1-2/3 inches in an average adult) may limp or have other difficulties when walking. Welcome to Limb Lengthening and Reconstruction Center of Yerevan. Other notable external fixators include Salamehfix (SLDF), Micro-Wound, Taylor Spatial Frame, and the Modular Rail System. No matter the reason, this article will summarize the four-step process and review the seven most common leg lengthening nails and methods. What is the recovery time after the surgery? Only one patient out of 131 total experienced a poor final outcome (0.77%). Positioning and splinting: The patient is positioned in bed by nurses and physiotherapists in order to reduce the edema of the patient after the surgery and to prevent contractures. Parents are usually the first to detect a leg length discrepancy when they notice a problem with the way their child walks. Because these differences require the patient to exert more effort to walk, he or she may tire easily. Dr.Yuksel Yurttas performs Precice Stryde, Precice 2, and LON methods with the highest success rates. General anesthesia Lengthening Over a Nail (LON) is relatively new technique that combines external fixator distraction osteosynthesis with the convenience of intramedullary nail. [7] Wang, K., & Edwards, E. (2012). Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology, 20(1), 30. https://doi.org/10.1186/s10195-019-0538-y. At this time, the external fixator (the ring) is attached. They may also be referred to as intramedullary nails, intramedullary rods, or telescopic nails. However, pin site infections are common and large pin holes required for stability may result in significant discomfort. this study is the only case-matched series of tibial lengthening using LON and the Ilizarov method. Notable improvements include the increased capability for weight bearing thanks to a revamped stainless steel composition. After full recovery, all physical activities and sports can be resumed. Achieve more extension thanks to the external fixator, . What we are trying to accoplish is giving the best . Dr. Donghoon Lee was the first in Korea to perform LATN successfully, in 2010, and he is one of the most experienced LATN surgeons in the world. The first extension is performed by the surgeon and taught to the patient. Walking begins from the next day after surgery by taking a few steps with a walker. The limb lengthening surgery is quite affordable in India compared to other countries. Closure of all incisions with aesthetic sutures This will inevitably result in complications with strength, alignment, and weight bearing potential, while significantly increasing the risk of refracture. Once the lengthening phase is completed, the external fixators are removed, and patients can gradually return to their daily life and increase the weight they put on their legs as the bone heals. The flexibility of your legs is also important. To extend the lower leg, the intramedullary nail is also inserted below the kneecap. In general, there are 2 methods used in cosmetic limb lengthening. However, it should be noted that patients will have limited mobility due to the external fixators, and they must follow the surgeon's instructions carefully during the entire treatment. Additional lengthening, although possible, increases the risk of complications. Clinical orthopaedics and related research, 472(11), 35493556. Transform your life with our advanced limb lengthening surgery methods. Irrespective of what hospital or treatment you choose, were with you at all the stages of your treatment: during the booking process, during the clinic visit, and during your recovery period. High pain was observed after week one (9.3 on the Visual Analogue Scale (VAS)), but was reduced to 0.3 one year after intramedullary nailing. Usually, the first 1-2 days after limb lengthening surgery are painful but our hospital uses both anesthesias (8hrs) and ultrasound-guided selective nerve block (36 hrs), so most of our patients have been dealing really well with the pain; we have both general anesthesiologists and subspecialty pain anesthesiologists to control the pain. It is the method in which an intramedullary nail is inserted into the bone and at the same time an external fixator is attached to the bone and lengthening is done by an external fixator. The final step in the process is the removal of the fixator, returning the patient to regular, unsupported function with their newly lengthened limb. PRECICE 2.2 is the last tech intramedullary motorized rod method. By gradually increasing the angle, joint motion is increased. Limb (Leg) Lengthening Methods, Nails & Process - How Does it Work? A 2017 study reviewed nine patients, of which seven achieved their lengthening goals (average 34.7 mm) [9]. In general, most external fixators are very similar in process and outcomes. It is imperative the new bone begins to develop prior to the onset of the lengthening phase. This method was a groundbreaking development compared to the original method that only involved the use of an external fixator (Ilizarov). In some cases, the cause of limb length discrepancy is "idiopathic," or unknown. The main reason for the price difference between limb lengthening methods is the type of technology and equipment used. 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. A broken leg bone can lead to a limb length discrepancy if it heals in a shortened position. The LON method is a combination of internal and external fixation, which is generally less expensive than the Precice 2 method, which uses a magnetic titanium nail for internal fixation. Journal of orthopaedic surgery (Hong Kong), 19(2), 204208. LON Method; Precice 2 Method; follow us Less risk of infection as minimal screws are attached to the bone, . Typically, the distraction rate is 0.25 mm or 0.33 mm per day, and the lengthening process takes approximately 60 days for 6 cm and 80 days for 8 cm. Limb lengthening surgery is a revolutionary procedure that utilizes the body's natural ability to regenerate new bone, allowing individuals to increase their height. Therefore, internal methods are usually a better option, but they come at a greater price point. Total lengthening of 1 millimeter is usually divided into four and applied every 6 hours. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2017 Dec 7. The surgery takes about 2 hours. Limb Lengthening with the LON Method | Everything You Need to Know - Dr. Yuksel Yurttas The LON method -Lengthening Over Nails- is one of the most preferred . Read more about : Leg lengthening surgery cost 2021, Read more about : Leg lengthening surgery before and after photos, Read more about : Leg lenthenening surgery success story. Unilateral limb lengthening 2. Physical therapy is crucial to ensure the development of strength and mobility in the limbs. Limb Lengthening with the LON Method | Everything You Need to Know - Dr. Yuksel Yurttas The LON method -Lengthening Over Nails- is one of the most preferred limb lengthening techniques in recent years with its affordable price and short-term use of an external fixator among advanced limb lengthening methods. Femur (thigh bone). The monorail fixator used in the femur LON method is located on the outer side of the thigh. Treatments such as stretching, strengthening, mobilization, pilates, balance, walking, electrotherapy, therapeutic massage are applied by our physiotherapists. [3] Novikov, K. I., Subramanyam, K. N., Muradisinov, S. O., Novikova, O. S., & Kolesnikova, E. S. (2014). Limb lengthening involves an intentional fracture of the bone to promote natural healing and elongation. CPM: CPM device is effective in restoring the patients ROM after surgery, preventing contracture and reducing edema. This is a special type of x-ray that uses a series of three images and a ruler to measure the length of the bones in the legs. It is very important to follow the patient closely during the extension period. With instant x-rays at every stage of the surgery, it is ensured that everything goes smoothly. When damage to soft tissue and bone occurs, the body naturally undergoes a natural regeneration process to fix the injured area. The clutch mechanism is activated by small rotational movements by the patient, enabling the nail to lengthen. Locking the distal end of the intramedullary nail to the bone Inside is a magnetic motor that generates the necessary force to lengthen the rod. Lower limb lengthening over an intramedullary nail: a long-term follow-up study of 28 cases. The circular frame fixator used in the tibia LON method has been modified so that our patients can use it more comfortably. Yonsei Kim And Chung Orthopaedic Clinic was started by professional joint and spine doctors from Yonsei Severance Hospital, focusing on the needed Era of Trustworthy Medical Centers. Based on this, we are overcoming the limitations of a university hospital and are known for professionalism, efficiency and the most suitable facilities for both physiotherapy and nurse teams. It is preferred by our surgeons because it does not cause deformity in tibia lengthening due to its circular structure. 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). Muscle lengthening if necessary Continued physical therapy should be a priority to assist with the natural recovery and return to normal operation. Walking: Generally, 24 hours after the surgery, our patients are given walking training by the surgeon and they make their first walk after the surgery. https://doi.org/10.1097/BOT.0b013e318238b5b1, [8] Lee, D. H., Ryu, K. J., Song, H. R., & Han, S. H. (2014). LiveLifeTaller 2021 - all rights reserved, Even after the treatment our team are there for you, We are with you every millimeter of your lengthening, Watch the video and get all the information you need. It also allowed for a maximum height gain of 6 cm for the tibia and 8 cm for the femur. The lengthening is carried out with a magnetic remote . Limb Lengthening in Turkey is cost-effective and hygienically, a contrast to other countries, $16.000 US Dollar for external fixator, $21.000 US Dollar for LON method, $45.000 US Dollar for intramedullary nail (PRECICE 2), $65.000 US Dollar for Precise Stryde, $14.000 US Dollar for limb shortening, $11.000 US Dollar for Limb Discrepancy, $8.500 US Dollar for Limb Correction Surgery (Bow Legs . Lengthening begins after 4-5 days since the operation. Lengthening over Nail (LON) uses both a ring fixator and an intramedullary nail. Overview of Benefits and Risks for Common Limb Lengthening Methods, general biological response to tension stress. Attachment of the external fixator to the bone via pins and wires. Bone length, osteotomy length, whole leg length and callus (new bone tissue) quality are checked by taking an x-ray of the entire leg before the removal surgery. This is the result of a series of adverse events reported, which are currently being investigated. After a median of 8 years post-operation, they observed 8 excellent results, 15 good results, 4 fair results, and 1 poor result. High reliability, in comparison to classical external methods. 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 (46 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. The Precice 2 method is a closed method that cannot be seen from the outside. LimbLengtheningSurgery.org. [5] Emara, K., Farouk, A., & Diab, R. (2011). Your email address will not be published. https://www.nuvasive.com/news/nuvasive-precice-stryde-system-used-in-first-patient-for-stature-lengthening-by-international-limb-lengthening-expert/. 4. Table 1. There is a risk of infection in the LON method, as there is an external fixator. Trauma correction. Throughout the period, the fixator will separate the bone segments incrementally. It may be tempting to try and expedite the process or increase total lengthening, but attempting to do so comes with increased risks and potential consequences. It also includes regular exercises and physiotherapy as part of the recovery process. In the two cases that were unsuccessful, there was a loss of achieved length (20mm and 10mm) after the lengthening of the nail, possibly due to premature weight bearing that prevented complete bone consolidation. https://doi.org/10.5812/atr.36273, [10] Young C, Adcock L. PRECICE Intramedullary Limb Lengthening System: A Review of Clinical Effectiveness [Internet]. At the AFA Limb Lengthening center, the medical team specializes in dressing and works professionally. Privacy Policy. After unassisted walking begins, other activities are quickly recovered and patients can return to their normal daily physical activities. Our surgeon performs LL surgery professionally with his team, with over 25 years of experience in the field of limb lengthening and deformity correction. We operate with the following methods: Precice 2, Precice Stryde, Lon method. It is the method in which an intramedullary nail is inserted into the bone and at the same time an external fixator is attached to the bone and lengthening is done by an external fixator. https://doi.org/10.1186/s10195-019-0541-3. https://doi.org/10.1177/230949901101900215, [6] Szymczuk, Vivian L. MD*; Hammouda, Ahmed I. MD*,; Gesheff, Martin G. MS*; Standard, Shawn C. MD*; Herzenberg, John E. MD* Lengthening With Monolateral External Fixation Versus Magnetically Motorized Intramedullary Nail in Congenital Femoral Deficiency, Journal of Pediatric Orthopaedics: October 2019 Volume 39 Issue 9 p 458-465 doi: 10.1097/BPO.0000000000001047. This procedure is frequently performed to lengthen an individuals legs or arms. Archives of trauma research, 5(4), e36273. With this information, you can be better prepared to assess the lengthening options available to you, and make an informed decision that offers the highest degrees of safety and satisfaction. The exact process for the Ilizarov Apparatus (described above) is followed to apply the external fixator and perform the distraction phase. Because an x-ray measurement cannot be compared with a CT scan measurement, your doctor will follow your child with the same type of imaging study over time. Patients are generally unhappy if they have to carry an external fixator on their leg for many months. Also the muscles will be initially weaker but with exercising you will regain the strength. concluded that surgeons should avoid use of this nail due to high rates of complications (in 53% of patients) and difficulties with rate control [8]. This LON methodology is highly preferred by patients for these simple reasons: . Limb Lengthening / Lon Method - Process - LiveLifeTaller 91% of patients were satisfied after week 6 and 94% at a one-year follow-up. Gait analysis. 3. LegLengtheningSurgery.com does not provide medical advice, diagnosis, or treatment. Intramedullary lengthening methods not involving external fixators can reduce this risk of infection, reduce pain and ugly scars and also reduce the mental stress experienced by patients. Alternatively, a break in a child's bone through the growth plate near the end of the bone may cause slower growth, resulting in a shorter leg. AFA Limb Lengthening center, physical therapy center, hydrotherapy pool are located in the same building. CLTFL for 10 cm by combination of LON and LATN techniques. X-rays. For all limb lengthening surgeries and other orthopedic diseases. We offer the most advanced limb lengthening methods, including Precice Stryde, Precice 2, and LON, with the highest success rates and the most affordable prices. He accepts patients from all around the world as an Orthopedics and Traumatology Specialist at Esencan International Hospital in Istanbul, Turkey.Visit the US National Library of Medicine website to access the academic studies and publications of Dr.Yuksel Yurttas.https://www.ncbi.nlm.nih.gov/search/all/?term=yuksel%20yurttasAssoc.Prof.Dr.Yuksel YURTTAS | Limb Lengthening Surgery in TurkeyBalareme mah. Dorsiflexion splint is used to prevent plantar flexion contracture, especially after tibia surgeries. , of which seven achieved their lengthening goals (average 34.7 mm) [9]. , a mean length increase of 35 mm was observed with no infections, malunion or joint contractures [7]. The lengthening rate is usually 1 millimeter per day. It is also more likely to happen if the skin and muscle tissue around the bone were severely injured and exposed, as occurs in an open fracture. Lengthening over Nails (LON) Method and Holyfix Method First, the distraction phase must not occur too slowly. Sergery stages; With our high skill level, we stubbornly continue to offer treatments that We would do for our own families. Our vision is to become the most reliable medical center which gives patients a clear diagnosis with the necessary treatment. All rights reserved. Fixators can be categorized as external fixators and internal fixators. It negatively affects the patients lengthening period and healing process. . The ability of the patient's muscles, nerves, and tissues to adapt to the new height, however, is the . AFA medical team and patient consultants are located at the building and meet all the needs of the patients. In the hospital, physical examination and gait control are controlled by our surgeon and his team. Limb Lengthening Surgery Services | Prof. Dr. Yuksel Yurttas . A 2019 study assessed the effectiveness of using intramedullary nails in 28 patients (Note: This study does not reference the effectiveness of the external fixator) [4]. Physiotherapy: If the patients blood levels are normal and the patient feels good, a physical therapy session is usually performed by our physiotherapist every day. +985138112029. The external fixator is removed after the desired lengthening is achieved. This article will address the four most common and relevant external methods. observed similar lengthening (A: 5.6 cm, B: 4.8 cm) and healing metrics between the two methods [6]. Radius/ulna (forearm bones). The third phase is consolidation, during which the regenerate bone hardens and calcifies. After the patient undergoes the surgery, there is around 3-5 days of hospitalization. 2023 Leg Lengthening Surgery. The price for the limb lengthening surgery in India is quite affordable. Limb Lengthening via LON (Lengthening Over Nail) method - YouTube Everthing About Limb lengthening. You can find our Surgery Cost information here: > Leg Lengthening Surgery Costs What is covered in the cost of surgery? In the LON method, daily lengthening is done with an external fixator. Lon Method. Day 9: Begining of distraction (1 mm per day for LON and 0,99 mm for Precice 2) Day 10-90: The duration of the lengthening phase may vary depending on the planned amount of height achievement.In this course of time, the number of physiotherapy sessions is determined considering your general status. As Limb Lengthening methods we use only the most reliable, safest and most succesful methods in the world for our patients. It allows for a maximum height gain of 6 cm for the tibia and 8 cm for the femur. After the intramedullary nail is removed, the process is completed. Therefore, it has a shorter recovery time for returning to daily life, just 15 days after surgery. The Journal of the American Academy of Orthopaedic Surgeons, 15(2), 97106. Sterilization, dressing materials and drugs used during dressing affect dressing success. Internal fixators are also commonly used in limb lengthening. Since the nail has a high weight bearing capacity, the patient can walk with full weight. A 2011 study of 32 patients observed an average lengthening of 7.6 cm with a mean follow-up duration of just over three years (38.7 months) [5]. [6] Szymczuk, Vivian L. MD*; Hammouda, Ahmed I. MD*,; Gesheff, Martin G. MS*; Standard, Shawn C. MD*; Herzenberg, John E. MD* Lengthening With Monolateral External Fixation Versus Magnetically Motorized Intramedullary Nail in Congenital Femoral Deficiency, Journal of Pediatric Orthopaedics: October 2019 Volume 39 Issue 9 p 458-465 doi: 10.1097/BPO.0000000000001047. Surgeons may perform limb lengthening surgery on the: Humerus (upper arm bone). . Limb lengthening history, evolution, complications and current concepts. Instead of rings that surround the limb like a scaffold, a single bar runs parallel to the limb and is attached with pins to the bone. There may also be a difference between the two sides of the face. Medication: Serum, vitamin mineral supplement, blood thinner, pain killer, antibiotic When there is any sign of infection, it is evaluated together with the surgeon, the dressing frequency is increased and antibiotic treatment is started. In most cases, the doctor will measure the discrepancy when your child is standing barefoot. It may take up to a year to go back to do competitive sports, such as, soccer, tennis, or basketball. . Most importantly, reasonable costs, in comparison to other latest systems such as PRECICE or STRYDE. Yonsei Kim And Chung Orthopedic Clinic combines the professionalism of doctors who have performed more than 5,000 joint and deformity surgeries, minimally invasive surgical procedures and high level limb lengthening and deformity correction surgeries. Early removal of external devices, which allows earlier return to regular daily life activities. Limb Lengthening Surgery | NewMe 37% of patients experienced complications (soft tissue or bone-related), however, the final outcome was rated as excellent for 55% of patients and good for 40%.

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