LON and LATN: two combined techniques

Lengthening with an external frame alone means wearing the frame until the new bone is strong. A published review of limb lengthening describes lengthening over a nail and lengthening followed by nailing as developed in order to shorten the external fixation period. Both keep the frame for the lengthening itself and use a nail inside the bone to support it.

This guide describes how the two techniques are carried out according to the studies that first described them. It does not use those studies' results: each compared its technique with classic frame lengthening in a matched group of patients, not LON with LATN, and their figures do not describe any individual's outcome.

A 1997 study describes the nail and the external fixator being applied together at the time of the bone cut. After gradual lengthening, the nail is locked and the fixator is removed. The International Center for Limb Lengthening describes the frame's pins and wires being placed around the nail so that they do not touch it, and the nail being locked with screws to prevent shortening once the frame comes off.

The same centre notes a consideration specific to having both at once: pin infections are common and may spread to the nail in the bone canal. How this is monitored is a reasonable question for any team proposing LON.

A 2008 study describes the frame being used for the gradual lengthening, after which a nail is inserted to support the bone during the consolidation phase, allowing early removal of the external fixator. The nail is therefore not in the bone while the frame is lengthening it, and inserting it is a separate operation.

The study's authors give avoiding the concurrent use of internal and external fixation as part of the technique's rationale. That is a description of the design, not evidence that one technique is safer than the other.

The table restates the two study descriptions above. Individual plans can differ from them, and the number and timing of operations is for the treating team to explain.

LATN appears among the techniques reported in a 2025 systematic review of aesthetic lower limb lengthening, alongside the Ilizarov method and motorized internal nails; the review concluded that further research with rigorous study designs is needed. LimbAtlas makes no claim that LON or LATN is better, safer or faster than the other or than any other technique.

Providers do not always use these names consistently, and some name packages or plans that combine different techniques in different bones. LimbAtlas records each provider's own wording on its profile and maps it to the techniques only where the provider's sources describe what is done. The method pages for LON and LATN list the providers that state each.