Limb lengthening surgery is a specialised orthopaedic procedure designed to increase the length of bones in the arms or legs. This procedure has the potential to significantly improve the quality of life for individuals with limb length discrepancies or deformities.
What is Limb Lengthening Surgery?
Limb lengthening surgery is a complex procedure that involves making controlled cuts in the bone and gradually separating the bone fragments to stimulate new bone growth. This process is typically achieved using an external or internal fixation device, which allows for precise control over the rate and direction of bone growth.
Indications for Limb Lengthening Surgery:
- Limb length inequality (discrepancy): This may be congenital (present at birth) or acquired due to injury, infection, or disease.
- Limb deformities: These can result from various conditions such as congenital anomalies, fractures that heal improperly, or bone diseases.
Benefits of Limb Lengthening Surgery:
- Improved symmetry and proportionality of the limbs
- Enhanced function and mobility
- Increased self-confidence and quality of life
- Correction of limb deformities, reducing pain and discomfort
The Limb Lengthening Process:
1. Pre-surgery evaluation: Dr Shales will conduct a thorough evaluation of your medical history, perform physical examinations, and may order imaging tests (X-rays, MRI, CT scans) to assess the extent of the limb length discrepancy or deformity.
2. Surgery: The surgical procedure involves making precise cuts in the bone (osteotomy) at the desired location. The bone fragments are then carefully separated to create a gap. An external or internal fixation device is attached to the bones to stabilise and control the gradual distraction (separation) of the bone segments.
3. Distraction phase: Once the fixation device is in place, the distraction phase begins. This involves adjusting the device at regular intervals to gradually pull apart the bone fragments, stimulating new bone formation in the gap. The rate of distraction is carefully monitored and controlled by your surgeon.
4. Consolidation phase: After the desired length is achieved, the distraction device remains in place to allow the newly formed bone to consolidate and strengthen. This phase typically lasts several months, during which time you will undergo regular follow-up appointments with your surgeon for monitoring and adjustments.
5. Removal of fixation device: Once the bone has fully healed and consolidated, the fixation device is removed in a minor surgical procedure. Physical therapy and rehabilitation may be recommended to help restore strength, mobility, and function to the limb.
In preparation for surgery you will have a number of appointments with Dr Shales and his team. Deciding to go ahead with limb lengthening surgery is a commitment to a journey and for the best outcome multiple people are involved in your care. Dr Shales and his team will ensure that the patient and caregivers are ready and prepared for surgery.
Post-operatively you will wake up in recovery with a bandage around your limb. Depending on the method of lengthening you may wake with a frame on your leg. The stay in hospital is usually 4-5 nights. When you return home it is important to:
- Follow your surgeon's instructions for wound care and pain management.
- Attend all scheduled follow-up appointments for monitoring and adjustments.
- Engage in physiotherapy and rehabilitation exercises as prescribed to improve strength, mobility, and function.
- Be patient and committed to the recovery process, as it may take several months for full healing and rehabilitation.
The first episode of lengthening will likely occur once you are home around the 7-10 day mark from surgery. We will ensure you or your caregiver are comfortable with this before being discharged home.
Rehabilitation plays a crucial role in the success of limb lengthening surgery. Physical therapy exercises are prescribed to improve range of motion, strength, and function. Patients will gradually increase weight-bearing activities as directed by their healthcare providers. Compliance with rehabilitation protocols is essential for achieving optimal outcomes.
As with any surgical procedure, limb lengthening surgery carries certain risks and potential complications. These may include:
- Infection at the surgical site
- Nerve or blood vessel injury
- Delayed or non-union of the bone
- Joint stiffness or contractures
- Discomfort or pain during the distraction process
- Complications related to the fixation device, such as loosening or breakage
Patients should be aware of these risks and discuss them with their surgeon prior to surgery.
Limb lengthening is a complex procedure with a lengthy rehabilitation process. In general, if patients maintain compliance on the lengthening schedule and more importantly the physiotherapy exercises the outcomes are great.
Limb lengthening surgery offers a promising solution for individuals with limb length inequalities or deformities, providing improved function, mobility, and quality of life. However, it is essential to understand the potential risks and commitments involved in the process. Consultation with a Fellowship trained Orthopaedic surgeon is crucial to determine whether limb lengthening surgery is appropriate for your specific condition and goals.
Here are a number of the questions we often get asked.
If your leg length discrepancy is significant and likely to impact your life or lead to potential long term problems then limb lengthening may be for you. Your surgeon will determine if lengthening your limb is appropriate.
We make specific cuts to the bone and then using either a intramedullary (in bone) device or external fixation (outside the bone) we gradually pull the ends of the bones apart.
