What Is Limb Lengthening?

Limb lengthening is a procedure by which an arm or leg can be lengthened.


In Which Cases To Resort To Limb Lengthening

Usually, this procedure is performed in cases where a limb is shorter due to a congenital condition (a child born this way) or an acquired condition (secondary to trauma, infection, segmental bone loss, childhood disease, or underlying bone disease).


The lengthening of the limbs can also be performed in both legs and arms for patients with the following conditions: dwarfism, short stature, or for aesthetic reasons. Cosmetic lengthening of the limbs can help these patients to achieve their ideal size.


Surgery to lengthen a limb requires an external or internal device attached to the bone. This device is located on either side of the area to be extended, and the bone is cut between the two attachment points. To the desired length, the bone is gradually lengthened at a rate of 1 mm/day, a process called distraction osteogenesis. Generally, a single bone can be extended by 6 to 8 cm. We can lengthen the arms (humerus, ulna, and radius) and the legs (femur and tibia).


Limb Lengthening Surgery



What Is Limb Lengthening Surgery?


Limb lengthening surgery is an operation performed by orthopedic surgeons to increase a person’s height by lengthening the bones of his legs. These surgeries are based on the ability of the body to create its new bone and surrounding tissues.


These surgeries are performed for cosmetic purposes or because of health problems such as leg length inequalities and congenital bone defects. An extension of 5 to 8 cm is generally preferred. An additional extension may be possible with an elongation of the lower and upper leg bones. Still, it would be best to remember that this situation will increase the risk of complications. The extension process will take place in a few months, depending on the value of the desired extension and the treatment’s total duration; generally, it lasts between 1 to 2 years.


Who Can Benefit From Limb Lengthening Surgery?


Causes such as genetic and hormonal factors, chronic diseases, and traumatic injuries can lead to short stature, uneven length of the legs, or bone deformities. These situations can lead to physical restrictions and problems in the person, as well as social and psychological effects. For all these reasons, many people prefer to increase their height for aesthetic purposes.


The purpose of these surgeries is to achieve bone maturity. The natural growth process in adolescents and children will occur at the ends of the bones with the help of growth plates. These plates fuse or close once the adult size is reached, usually when the average teenager reaches the age of 17 to 21. As a person grows, the formation and healing of new bone tissue slow down, so the most appropriate age range for this type of surgery is between 20 and 45.


However, in some cases, such as dwarfism, starting the treatment at an early childhood age is mandatory, depending on the patient’s bone structure.


Since the postoperative recovery process depends on the body’s ability to form its bone and surrounding tissue, smoking and the patient’s health status are important factors that can affect the healing process.


How Is Limb Lengthening Surgery Performed?


This surgery is mainly performed by lengthening the upper and lower leg bones, the femur, and the tibia.


First, the bone that will be lengthened is cut during surgery by a particular procedure called an osteotomy. After that, the leg bone is fixed using different methods and devices (external or internal fixation devices). Then the two ends of the cut bone are slowly and continuously moved apart by 1 mm per day using a particular device. Once the desired length is reached, the lengthening process is stopped.


Finally, new bone tissue, soft tissue, ligaments, blood vessels, and nerves form in the space between the ends of the cut bone during the limb lengthening process. The bone tissue created gradually consolidates and becomes firm.


What Should I Do After Limb-Lengthening Surgery / What Is The Recovery Process?


Lengthening is a process that requires time, patience, and precision. During an average lengthening, 4 to 6 months may be necessary for the bone to heal and strengthen. First, the patient must use supports to walk, such as crutches. After a while, he can slightly press his leg and walk without these supports. In addition, he must follow physiotherapy programs to have a good development of movement and functions of the elongated limbs. When the treatment is completed, the external or internal fixation device is removed from the leg.


What Are The Techniques Used In Limb Lengthening Surgery?


Three methods are used in this type of surgery to stabilize the leg and obtain the desired lengthening :


External Method :


In this method, external fixators are used and fixed on the outside of the leg with pins or wires connected to the bone parts.


Internal Method :


Nail-shaped metal rods will be placed inside the bone to stabilize the leg. These nails are extended by an external adjustment by the patient using a remote control. There will be no devices attached to the outside of the body.


Mixed Method :


In addition to the previous methods, a third technique can be used in this type of surgery by combining the first two methods.


What Is A Precise Intramedullary Nail, And How Does It Work?


Precice is a limb extension system composed of intramedullary (internal) nails and screws inserted into the bone, designed to lengthen the thigh and shin during lengthening surgery. There are no parts attached or viewed from the outside of the body. The external remote control is used to lengthen the Precice nail daily and even shorten it if necessary.


  1. During the lengthening surgery with Precice, the bone to be lengthened is cut in the first step, and a space is created between the bones. The Precice nail, which will prolong the limb, is inserted into the bone along the designed length. This nail is controlled externally by the patient with remote control.


  • The external remote control and the Precice nail work magnetically, so to create the daily extensions, it is only necessary to place the device near your leg. Thus, the space between the cut bones is extended to a total of 1 mm every day.


  • This is how the desired extension is obtained in a few months. Then the bone begins to heal, and new bone tissue is formed.


In a short time, the patient gets up and starts walking with the help of supports such as crutches. After a few weeks, he can begin a second stage in which he gradually uses his leg and walks without assistance.


Nails and screws inserted into the bone are removed 1 to 2 years after surgery. The nail is removed with small incisions and through outpatient surgery.


The patient can resume his activities and daily routine during recovery even if the Precice nails are implanted in his legs. Still, he can, in no case, continue sports or perform movements requiring physical effort until these nails are removed.