LON VS LATN TIBIAS ADVICE

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I'm curious to know the better option between these two as well. LATP sounds really interesting...

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Most of the doctors prefer LON, becuase is easier than LATN and has fewer risks. Good luck.

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Quote from: onemorefoot on January 22, 2017, 10:12:18 PMMost of the doctors prefer LON, becuase is easier than LATN and has fewer risks. Good luck.

Looking at the different methods of LL, the pros and cons of both seem to be the following:-

LON (Lengthening Over Nail)

Advantages: Requires only 1/3 of the time wearing an external fixator as compared to the purely external method. Intramedullary nail helps prevent misalignment in regenerate bone. Fewer complications than external method overall.

Disadvantages:  Higher rate of pin site infection due to presence of intramedullary nail during lengthening. Requires acute deformity correction which compromises bone healing potential during subsequent lengthening. Comparatively high incidence of deep intramedullary infection. Additional surgery required to remove intramedullary nails years later. Need to be careful of impact on intramedullary nails during consolidation due to risk of re-fracture. Doesn’t appear to reduce the duration needed for bones to heal compared to purely external method. Unlike LATN, LON uses a small diameter nail so bone can regenerate over it, allowing less stability than LATN method. Discomfort and soft tissue tethering due to pin sites.

LATN (Lengthening and then Nailing)

Advantages: Requires only 1/3 of the time wearing an external fixator as compared to the purely external method. Quicker bone healing rate than pure external method. Lower rate of infection than LON. Infections can be treated more easily and gradually during lengthening due to absence of intramedullary nail present in LON method during lengthening phase. Larger diameter nail than the one used in LON method is inserted into bone cavity during consolidation, allowing greater stability and increased protection against re-fracture.

Disadvantages:  May require repeated adjustments to avoid bone misalignment due to lack of IM nail during lengthening phase. Need to be careful of impact on intramedullary nails during consolidation due to risk of re-fracture. Discomfort and soft tissue tethering due to pin sites.

The disadvantages of LON do seem to outweigh those of LATN though.

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Good info I found here by Dr. Donghoon: http://www.drdonghoon.com/index.php/archives/2414?ckattempt=3

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the only method that has reported knee pain after consolidation is internal tibia which is why people prefer external tibia but as far as im concerned unless they lived all their life even the ones that went thru it dont know if its permanent . never heard of lon causing permanent knee pain infact people decide on external over internal to prevent knee pain