Limb lengthening is a surgical procedure that aims at using the body's capacity to regenerate new bone. The focus is on the bone and the soft tissues, blood vessels, ligaments, and nerves surrounding and supporting it. As late as the 1980s, people in the United States who had limb length discrepancies had few treatment options. All that has changed, thanks to an innovative limb lengthening surgery developed a few years ago.
The process starts with a surgery called osteotomy to correct congenital short statures and limb length discrepancies.
The procedure also addresses:
- Congenital disabilities that contribute to congenitally short limbs
- Skeletal abnormalities
- Legg-Calve-Perthes disease
How Does Limb Lengthening Work?
During the limb lengthening surgery, the doctor cuts the target bone to create two separate segments. Additional soft-tissue procedures are also involved in the process to prepare the muscles and nerves for lengthening. The doctor then applies an orthopedic lengthening device to the bone. Lengthening devices are either internal or external.
After surgery, the bones are given time to rest, usually five to seven days for the healing process to start. This is known as the latency period, after which the patient or a family member adjusts the orthopedic device to pull apart the two bone segments slowly.
The Height Lengthening Process
Limb lengthening is a gradual process that may take anything between a few weeks and several months to complete. The gradual process is known as a distraction, which means "pulling apart." As this happens, a regenerate bone forms between the two segments, increasing the bone's overall length. As the bone continues to grow, it spreads the gap by about 1/4mm with each adjustment. It is recommended to adjust the devices four times a day, which yields 1mm (0.04 inches). The body continues to generate new tissue within the gap until the desired bone length is achieved.
While the intended results may be evident in a few weeks, healing may not be complete until several months later. During the distraction phase, the patient needs to attend physical therapy two to five times a week. This is to ensure the bone lengthening process is not happening too fast or too slow.
Limb Lengthening Consolidation Phase
After the distraction phase is the consolidation phase that makes the regenerate bone gradually harden. The period this stage takes depends on the amount of lengthening achieved. For example, in the case of 2-inch lengthening, consolidation takes about two to three months. The device would remain in place for four to five months. The new bone is not completely healed until it hardens and calcifies.
For the bone to heal correctly, the patient should eat a healthy diet and keep off nicotine in all its forms. It's also essential to put some weight on the limb using a walker to encourage the bone to heal and harden. Towards the end of the treatment period, the patient won't need to use crutches.
The orthopedic lengthening device can be removed after the regenerate bone fully consolidates. The process doesn't take long, and an overnight stay in the hospital is not necessary. For the protection of the new bone, the doctor may apply a cast. Alternatively, the patient will wear a brace for a few weeks after the removal of the external fixator.
What Happens if Limb Lengthening is too Fast?
Each individual responds differently to limb lengthening, with some bones healing very fast. The regenerate bone may also harden before treatment is complete, resulting in premature consolidation. Once this happens, it's not possible to pull the bone segments apart anymore.
In such a situation, one option is to increase the rate of pulling the segments apart. This could be from 1mm per day to about 2mm per day. The surgeon may also cut the bone to allow lengthening to continue, usually in an outpatient procedure.
What Happens if Limb Lengthening is Too Slow?
Other bones may take too long to heal, and the regenerate bone may not have enough time to form. This is common in people with diabetes and those who smoke.
If the regenerate bone forms poorly, the orthopedic device can be adjusted to shorten the bone temporarily. This allows the regenerate bone to improve. A more aggressive approach to correcting the condition entails grafting, which means inserting bone tissue into the gap between the segments. As the regenerate begins to fill the gap, lengthening of the bone can continue.
Another thing that might occur is that the soft tissues may resist stretching during lengthening, causing them to become very tight. Physical therapy sessions can help increase the amount of stretching if done two to five times a week.
Eligibility for Height Lengthening Surgery
The first step towards limb lengthening is having a thorough evaluation done by an experienced orthopedic surgeon. Patients may sometimes realize that what they thought was a discrepancy in limb length may be a different medical condition. They may also have a mistaken perception of the inequality of limb length.
Limb lengthening surgery can be safely carried out in adults in the 20s to 50s who want to lengthen their height. In addition to meeting the physical criteria for the procedure, a patient must also be highly motivated. They must be willing to play an active role in:
- Remote control adjustments
- Physical therapy
- Regular doctor appointments
- Healthy eating
Why Come to Height Lengthening for Limb Lengthening Surgery?
Limb lengthening procedures are long and demanding. It's crucial to have the surgery performed by experienced surgeons who understand what it takes for the process to be successful. It's also vital to attend regular scheduled physical therapy sessions to promote the recovery process and prevent complications.
At Height Lengthening, we have one of the most qualified and experienced orthopedic surgeons. We offer comprehensive treatment, ensuring we take our patients through all the options and customize the best treatment plan to meet their needs. Our patients benefit from a team-centered approach that helps them achieve the best possible results from the height lengthening surgery.