Clinical Outcomes and Complications of Bilateral Cosmetic Femoral Lengthening Using the Lengthening over Nail Technique: A Single-Center Retrospective Study

Background: The primary objective of this study is to evaluate the clinical experience, efficacy, and limitations of the Lengthening Over Nail (LON) technique in cosmetic bilateral femoral lengthening. Methods: A retrospective analysis was conducted on 48 patients (44 males, 4 females) with constitutional short stature who underwent surgery between January 2022 and December 2023. Demographic data, preoperative height, lengthening ratio, time to full weight-bearing, and complications were evaluated. The association between variables was analyzed using Spearman’s rank correlation and Chi-square tests. Results: The mean age of the participants was 31.5 ± 9.43 years. A statistically significant weak negative correlation was observed between age and the amount of lengthening achieved (p = 0.038) as well as the lengthening ratio (p = 0.037). No significant difference was found in the mean age or lengthening ratio between patients with and without complications. The relationship between time to full weight-bearing and complications showed a trend toward significance (p = 0.068). Discussion: The LON technique is a sophisticated and reliable approach for aesthetic limb lengthening that integrates internal and external fixation to enhance stability and reduce external fixation duration Conclusions: While increasing age may be associated with slightly reduced lengthening outcomes, the procedure demonstrates acceptable complication rates when combined with careful patient selection and rigorous rehabilitation.