Limb Lengthening

Limb lengthening is a treatment that entails extending the bones in the arms and legs. This is done in stages so that the bones and soft tissues (skin, muscles, nerves, and so on) gradually lengthen.

The procedure usually takes many months. Limb lengthening can be paired with deformity repair, either progressive or acute. The humerus (upper arm bone), radius/ulna (forearm bone), femur (thigh bone), tibia (shin bone), and metatarsals (foot bones) are all routinely lengthened.

How Limb Lengthening Works

The doctor will cut the bone into two separate parts during surgery. An osteotomy is a surgical technique that involves cutting a bone.

To prepare the muscles and nerves for lengthening, further soft-tissue treatments may be performed at the same time. The Achilles tendon, for example, could be surgically lengthened to make tibial (shin bone) lengthening easier. An orthopedic lengthening device will also be applied to the bone by the doctor.

Internal devices, such as the Precice nail, are orthopedic lengthening devices that are placed into the bone. External fixators, such as the Taylor Spatial Frame or the Ilizarov device, are orthotic lengthening devices that remain outside of the body.

External Fixator- A metal frame called an external fixator rests outside the leg and is fastened to the bone using wires, screws, and pins. To extend the distance between the two sections of the leg bone that were sliced, the external fixator can be adjusted from the outside.

Internal Lengthening Nail– A motorized metal nail or rod called an internal lengthening nail is introduced into the leg bone’s bone marrow cavity. A magnet inside the nail is rotated under control by a remote control device.

The bones are allowed to rest for five to seven days after surgery to allow the healing process to commence. Latency period is the name given to this period of time. Following the latency period, the patient will adjust the orthopedic device so that the two bone segments are slowly pulled apart. The gradual separation of the two bone segments is known as distraction, which literally means “drawing apart.” New bone grows in the area between the two bone segments as they are gently forced apart. This new bone extends the bone’s overall length. Regenerate bone is the name given to the new bone.

The patient (or a family member) adjusts the orthopedic device every day during the distraction phase such that the bone segments are moved apart at a slow rate of about 1 mm (0.04 inches) every day. This rate may vary slightly depending on the bone. The treatment plan can be to distract 0.75 mm every day in the tibia but 1.0 mm per day in the femur or humerus, for example. The body is forced to constantly produce new bone and soft tissues such as skin, muscles, nerves, and blood vessels as a result of this gradual distraction. The distraction phase lasts until the required length of the bone has been achieved.

Each month, you can gain about 1 inch (2.5 cm) in length. During the distraction phase, the patient will need to see the doctor many times a month to ensure that the bone is not lengthening too quickly or too slowly. The rate of distraction may be accelerated or slowed depending on the look of the regenerate bone on an X-ray. The patient will need to go to physical therapy two to five times per week during the distraction process.

The metal lengthening device will remain in place after the desired length is reached for several months so that the bone can finish healing and solidifying. In a subsequent outpatient surgery, the lengthening device will be removed.

Once the new bone has fully developed, it has the same strength as other bones and is not more susceptible to deterioration or fracture.

Am I a good Candidate for Limb Lengthening Surgery?

Many people who are candidates for leg lengthening surgery have two legs or arms that are different lengths due to:

• A congenital defect
• Growth plate damage to a leg bone when you were a toddler
• A preexisting fracture that has not healed at all

Leg lengthening surgery may be appropriate for patients with skeletal dysplasias or other bone diseases. Other disorders that can result in a substantial leg length disparity that necessitates leg lengthening surgery are:

• Poliomyelitis
• Cerebral palsy
• Legg-Calve-Perthes disease

Many patients also choose this operation to increase their height by a few inches.

If you are suffering from any of the above deformities or are looking to increase your height, are otherwise in good health, you may be a candidate for limb lengthening surgery.