Simultaneous Lengthening and Deformity Correction over Customized Intramedullary Locking Nail (LON) for Multidimensional Deformity of the Proximal Tiba

Deformity correction using intramedullary (IM) nailing is a well-established technique. Integrated techniques like lengthening over nail (LON), lengthening and then nailing (LATN), lengthening and then plating (LAP), and lengthening along a plate (LAAP) can substantially reduce external fixation time. This is the case of a 17 year old patient with biplanar malalignment of the proximal tibia with minor rotational deformity and shortening. All aspects of the deformity could be addressed using a LON technique with a distraction index (DI) of 1 mm/d, an external fixation index of (EFI) 21 d/cm, and a weight bearing index (WBI) of 34 d/cm. The final result was excellent with fast recovery and early return to sports. The latest follow-up after 2.5 years confirmed full recovery.