Pain Beliefs and Functional Performance After Cosmetic Limb Lengthening Using the Lengthening Over Nail (LON) Technique (LON-PILOT)

Investigation of the Relationship Between Pain Beliefs, Pain Intensity, and Functional Performance in Individuals Undergoing Cosmetic Limb Lengthening Using the Lengthening Over Nail (LON) Technique: A Cross-Sectional Pilot Study

This pilot observational study aims to examine the relationship between pain beliefs, pain intensity, and functional performance in individuals who have undergone cosmetic lower limb lengthening surgery using the Lengthening Over Nail (LON) technique.

Seventeen healthy male participants aged between 20 and 50 years who have undergone bilateral lower limb lengthening with the LON method will be included in the study. All evaluations will be performed during a face-to-face clinical visit at the fourth postoperative week.

Pain intensity will be assessed using the Visual Analog Scale (VAS). Pain beliefs will be evaluated using the Pain Beliefs Questionnaire. Functional performance will be measured with the 6-Minute Walk Test (6MWT).

The study aims to better understand how patients' beliefs about pain may influence their perceived pain level and physical performance after cosmetic limb lengthening surgery. Findings may contribute to improving postoperative rehabilitation planning and patient management.

Study Overview

• Status: Not yet recruiting
• Conditions: Postoperative Pain After Limb Lengthening; Limb Lengthening
• Intervention / Treatment: Diagnostic test: Postoperative Functional and Pain Assessment

Detailed Description

This study is designed as a descriptive, cross-sectional pilot study. The objective is to investigate the relationship between pain beliefs, pain intensity, and functional performance in individuals who have undergone cosmetic bilateral lower limb lengthening surgery using the Lengthening Over Nail (LON) technique.

Background: Cosmetic limb lengthening procedures have increasingly been performed not only for limb length discrepancy but also for aesthetic purposes. Although the surgical technique has advanced over time, postoperative functional outcomes and psychological factors influencing recovery require further investigation. Pain beliefs, which may include both organic and psychological components, can influence pain perception, coping strategies, and physical performance during rehabilitation.

Participants: Individuals aged between 20 and 50 years who have undergone bilateral lower limb lengthening surgery with the LON technique and who have completed the early postoperative rehabilitation phase will be eligible. Participants with neurological, rheumatological, systemic diseases, major postoperative complications (e.g., infection, implant failure), or conditions limiting physical activity will be excluded.

Procedures: Participants will be invited for a face-to-face clinical evaluation at the fourth postoperative week. During this visit, the following assessments will be performed:

Demographic and clinical data collection (age, sex, body weight, external fixator distraction amount)

Pain intensity assessment using the Visual Analog Scale (VAS)

Pain beliefs assessment using the Pain Beliefs Questionnaire

Functional performance evaluation using the 6-Minute Walk Test (6MWT)

All measurements will be conducted under standardized conditions and supervised by a physiotherapist.

Outcome Measures:

The primary outcomes are pain intensity (VAS score), pain beliefs (Pain Beliefs Questionnaire scores), and functional performance (6MWT distance). The study aims to determine whether significant relationships exist between pain beliefs and functional performance, as well as between pain intensity and physical capacity.

Significance:

Understanding the interaction between psychological factors and functional outcomes after cosmetic limb lengthening surgery may contribute to improving postoperative rehabilitation strategies and individualized patient management

• Study Type: Observational
• Enrollment (Estimated): 58

Contacts and Locations

• Study Contact: Name: Fatma Cavdarci, PhD Candidate; Phone Number: +905374590918; Email: cvdrcftm@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

The study population consists of adults aged 20 to 50 years who underwent bilateral lower extremity cosmetic lengthening surgery using the LON (Lengthening Over Nail) technique and are attending routine postoperative follow-up at week 4 in a single tertiary care center.

Description

Inclusion Criteria:

• Age between 20 and 50 years
• Underwent bilateral lower extremity cosmetic lengthening surgery using the LON (Lengthening Over Nail) technique
• Completed postoperative rehabilitation process
• Attending routine clinical follow-up at postoperative week 4
• Able to understand and complete questionnaires
• Provided written informed consent

Exclusion Criteria:

• History of orthopedic surgery other than lower extremity lengthening
• Presence of neurological, rheumatologic, or systemic diseases affecting physical performance
• Postoperative complications such as infection, pseudoarthrosis, or implant failure
• Any condition preventing participation in physical assessment
• Incomplete clinical records

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Postoperative LON Patients; Individuals aged 20-50 years who have undergone bilateral cosmetic lower limb lengthening surgery using the Lengthening Over Nail (LON) technique and who are evaluated at the fourth postoperative week.

Diagnostic test: Postoperative Functional and Pain Assessment; This study does not administer any therapeutic intervention. Participants undergo standardized postoperative assessments at the fourth week after cosmetic lower limb lengthening surgery using the LON technique. Assessments include the Visual Analog Scale (VAS) for pain intensity, the Pain Beliefs Questionnaire for evaluation of pain-related cognitions, and the 6-Minute Walk Test (6MWT) for functional performance measurement.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain Intensity Measured by Visual Analog Scale (VAS)	Pain intensity assessed using the Visual Analog Scale (VAS). The scale ranges from 0 (no pain) to 10 (worst imaginable pain). Higher scores indicate greater pain intensity.	Postoperative week 4

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain Beliefs Measured by Pain Beliefs Questionnaire (PBQ)	Pain beliefs assessed using the Pain Beliefs Questionnaire (PBQ). The questionnaire includes organic and psychological subscales. Items are scored on a Likert scale, with higher scores indicating stronger pain-related beliefs.	Postoperative week 4

Collaborators and Investigators

• Sponsor: Istanbul Aydın University
• Investigators: Principal Investigator: Gozde Basbug, MD, PhD, Istanbul Aydın University

Study record dates

Study Major Dates

• Study Start (Estimated): March 1, 2026
• Primary Completion (Estimated): June 1, 2026
• Study Completion (Estimated): July 1, 2026

Study Registration Dates

• First Submitted: February 23, 2026
• First Submitted That Met QC Criteria: February 23, 2026
• First Posted (Actual): February 27, 2026

Study Record Updates

• Last Update Posted (Actual): February 27, 2026
• Last Update Submitted That Met QC Criteria: February 23, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: Postoperative pain; 6 Minute Walk Test; Functional performance; Pain beliefs; Lengthening Over Nail; LON technique; Cosmetic limb lengthening
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Pain, Postoperative; Diagnostic Techniques and Procedures; Diagnosis; Physical Examination; Neurologic Examination; Pain Measurement
• Other Study ID Numbers: IAU-LON-PAIN-2026-01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data (IPD) will not be shared. The study is a single-center academic research project conducted as part of a doctoral dissertation. Data contain sensitive health information and no data-sharing agreement or repository plan has been established.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No