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Lengthening Over Nail (LON)
The traditional Ilizarov frame is a heavy external structure that must remain attached throughout both the lengthening and consolidation phases. Prolonged frame use can cause discomfort and increase the risk of complications.
To reduce the duration of external fixation and improve patient comfort, the Lengthening Over Nail (LON) technique is used.
How Lengthening Over Nail Works
Step 1 – Initial Surgery
- Controlled osteotomy (bone cut)
- Insertion of intramedullary nail
- Application of external fixator frame
The frame remains in place until the desired length is achieved through gradual distraction.
Step 2 – Frame Removal & Nail Locking
- External fixator removal after distraction phase
- Intramedullary nail locked with screws
- Stabilization during consolidation period
Patients are allowed early mobility and partial weight-bearing with crutches or walker support.
Benefits of Lengthening Over Nail
Significantly reduces external fixation time
Lower complication rates compared to prolonged frame use
Improved comfort during consolidation phase
Prevention of axial deviation during and after fixation
Maintains structural stability for long-term alignment
The combination of intramedullary nailing with an external fixator offers a balanced approach — minimizing frame duration while maintaining safety and biomechanical stability.