The Ilizarov Method and LATN
The original circular frame, used by a surgeon who learned it in Kurgan, and the LATN variant that places a nail after lengthening. When the classical method is still the right choice.
Medically reviewed by Prof. Arshak Mirzoyan, MD, DMedSc. Last reviewed 13 October 2026.
The Ilizarov apparatus is a circular external frame of rings and thin tensioned wires. It is the device with which distraction osteogenesis was invented, and in experienced hands it still offers something no internal device can match: the ability to adjust alignment, rotation and length in three dimensions, every day, without another operation.
Classical Ilizarov lengthening
The frame is fixed to the bone with wires and half-pins, an osteotomy is performed, and lengthening proceeds at about a millimetre a day. Because the frame also holds the bone through consolidation, it stays on until the new bone is solid, typically six to nine months. Weight bearing is allowed early, which helps the bone mature. The method is chosen when the bone, a previous operation, a deformity that needs correcting at the same time, or the patient’s circumstances make an intramedullary nail the wrong choice.
LATN: lengthening and then nailing
LATN uses the frame for the distraction phase only. When the target length is reached, an intramedullary nail is inserted in a second procedure and the frame is removed, so the time in the frame is shorter than with classical Ilizarov, and the nail protects the regenerate during consolidation. It combines the control of the frame during lengthening with an earlier return to normal clothing and movement.
Where the method came from
Prof. Mirzoyan spent 1980 to 1989 in Kurgan at Prof. Ilizarov’s institute, defended his doctoral thesis on the Ilizarov technique, and helped establish an Ilizarov centre at Aalborg Hospital in Denmark. He is an honorary professor of the Ilizarov Centre and a member of ASAMI, the association for the study and application of the method. Few surgeons offering cosmetic lengthening learned the frame at its source.
Trade-offs
- Longer in a frame than LON, and a bulkier frame.
- More pin sites to care for, and the same discipline about daily cleaning.
- Unmatched control: deformity correction and lengthening can be done at once.
- Lower hardware cost; the all-inclusive price starts from $[X].
Who it suits
Patients lengthening the tibia by up to 6 to 7 cm, patients who also need an angular or rotational correction, patients whose bone canal is not suitable for a nail, and patients who prefer the lowest-cost path and can accept the longer time in a frame.
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