Distraction osteogenesis is an effective method for lengthening, deformity correction, and treatment of nonunions and bone
defects. The classic method uses an external fixator for both distraction and consolidation leading to lengthy times in frames
and there is a risk of refracture after frame removal. We suggest a new technique: lengthening and then nailing (LATN) technique
in which the frame is used for gradual distraction and then a reamed intramedullary nail inserted to support the bone during
the consolidation phase, allowing early removal of the external fixator. We performed a retrospective case-matched comparison
of patients lengthened with LATN (39 limbs in 27 patients) technique versus the classic (34 limbs in 27 patients). The LATN
group wore the external fixator for less time than the classic group (12 versus 29 weeks). The LATN group had a lower external
fixation index (0.5 versus 1.9) and a lower bone healing index (0.8 versus 1.9) than the classic group. LATN confers advantages
over the classic method including shorter times needed in external fixation, quicker bone healing, and protection against
refracture. There are also advantages over the lengthening over a nail and internal lengthening nail techniques.
Level of Evidence: Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
The institution of the authors has received funding from Smith and Nephew, Inc (Memphis, TN) and EBI, Biomet (Parsippany,
NJ).
Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations
were conducted in conformity with ethical principles of research, and that informed consent for participation in the study
was obtained.