Limb Lengthening Surgery

Limb lengthening surgery is a type of surgery that has recently become popular. This surgery is predominantly conducted to correct the difference in the lengths of the limbs. The surgery is also known to correct the condition of dwarfism, people who are born with a height that does not match up to the average standards of the society. Limb lengthening procedure involves a procedure called osteotomy, in which the bone that requires lengthening is cut. This is a bone lengthening surgery in which the surgery is performed either on the upper or lower part of the leg. There are devices that are fixed internally or externally to stabilize and bring about a significant change in the length of the limb, thereby increasing the height of the individual. During the surgical procedure, anesthesia is used in order to decrease or eliminate the pain factor totally. As the bone is cut and slowly stretched, the bone has room to grow from where the cutting and stretching has occurred. During the tenure, the devices for the cosmetic limb lengthening surgery that are fixed for stabilization are adjusted in length. The devices can be adjusted up to 4 times a day to make it a total of a 1 mm increase per day. The devices have to be adjusted in this manner until the optimum length is achieved. The limb lengthening surgery costs around $30,000 to $50,000, excluding the preceding costs of the procedure.

Most of the leg lengthening procedures used today are variations on the Ilizarov method, devised by a Russian physician Gavril Abramovich Ilizarov in 1951. This is the former method on which the variation of new methods have been based.

Phases of Limb Lengthening Surgery

There are four phases of this surgery.

Preparation
The preparation phase involves the patient consulting the surgeon. The initial consultations with the physician are very important in order to understand the depth, the pros and cons of the surgery. The physician should be well-equipped with information and must explain everything about the operation and recovery with clarity, so that no doubts remain; and as time progresses with the surgery, there should be no regrets cropping up in the mind of the individual who has undertaken this surgery. X-rays are conducted in order to make the Ilizarov external fixator device customized for the patient. There are some centers that perform a psychological evaluation test in order to understand and ensure that the patient will be able to go through the entire procedure, and will continue to have strong willpower during and after the procedure is conducted.

Surgery
During the surgery, the most common procedure involves breaking the tibia and fibula bones of both lower legs and attaching an external fixator device to each half of the severed bone. The device is attached to the bones with pins or wires. These pins and wires are drilled into the skin through holes that are spiked through the patient's skin.

Lengthening
This phase begins about a week after surgery and is also referred to as distraction. This procedure continues for more than two months, depending on the amount the lengthening desired. The fixator device is lengthened through stretching and thereby steadily increasing the distance between both the halves of each bone. There is a new bone that grows in the space provided by stretching in between. The lengthening is slow, the increased measure is about 1mm a day. There is a screw affixed that is turned four times a day to achieve the 1mm per day separation. External fixator devices may also be motorized to achieve continuous lengthening throughout the process. Patients should be scheduled for one to two hours of therapy each day during lengthening. By the end of this phase, the lower legs have been increased two to three inches. During the lengthening process, the individual has to use a wheelchair. The patient must ensure that no weight is borne on the growing bone.

Strengthening
This phase is termed as the consolidation phase, where the patient, for the next three to six months continues to use the wheelchair until the bone becomes strong enough to bear the body weight all over again. The fixator device is continued for use as the device is capable of keeping the bones aligned and stable. This fixator device is no longer screwed for the purpose of lengthening. For bone strengthening, the sessions can be reduced to three times per week. At the end of the sessions, a simple operation is performed to detach the fixator device. After this is done, the patient can walk without any support and no longer needs a wheelchair. However, there is cast that is provided to the patient to provide additional support and protection to the legs.

Additional lengthening is performed to achieve a greater height. There are some patients who would want to opt for a second procedural operation. Once the lower legs are strong and you are able to walk with ease, the femur bones of the thighs are broken and lengthened. This procedure is called the femur lengthening surgery. This will increase an individual's height significantly, almost by an additional six inches. However, this may make the individual look disproportional. In addition to this, the time, energy, pain and the confinement on the wheelchair for another half year or more, are some of the reasons why a second surgery is not recommended. There have been instances where people have opted for upper and lower parts of the legs to be lengthened. However, this is not advisable, and the success rate has not been good in terms of the recovery period.

Risk and Complications of the Limb Lengthening Surgery

• There are probabilities that bone infection may occur resulting in stiffening of the joints.
• Bacteria enters the body through a wound. Chills, high fever, and severe pain are some of the symptoms of bone infection. Intravenous antibiotic treatment can help in fighting the infection.
• If the blood vessels are injured, the blood circulation can be impaired and bone growth is hampered.
• There may be possibilities that the bone may heal by consuming a lot more time than expected. This may include the new bone not forming in unison with the old bone.
• If there is severe nerve injury, the patient could become numb in the lower leg. In extreme cases, the patient's leg may become useless.
• There may be a slight difference in the length of the two legs. If the healing has not been taken care of in an appropriate manner, there may be chances that the fixator device has to be reversed to make the necessary changes.
• The expected or the estimated height may be less than expected. There are many instances where the patient may achieve an increase of only half an inch in height, rather than the expected complete three inches.

Remember that the entire leg lengthening procedure is extremely painful to endure. One needs to be strong and self motivation is extremely important. This surgery is indeed not for the faint-hearted. Constant pain hinders the recovery period. Anti-inflammatory drugs are prescribed only when the pain is unbearable or there is any other emergency. However, the administration of the same has been shown to increase the time required for bone growth. Chronic pain may prevent the patient from doing physical therapy during the lengthening and strengthening phases. The patient must get enough sleep during and after the limb lengthening surgery, and must continue doing so during the recovery period as well.