Limb lengthening is a highly specialised orthopaedic process dedicated to increasing the length of one or more limb segments. It relies on so-called distraction osteogenesis – a process where the long bone is cut, and once it starts healing through the formation of a bone regenerate, the bone ends are pulled apart and the regenerate undergoes a controlled and gradual stretching that stimulates regenerate growth and new bone formation.
Limb lengthening surgery was primarily developed to correct bone length differences to equalise limbs and in congenital syndromes which affect limb growth. The limb length discrepancies may be the results of congenital diseases, post-traumatic injuries or bone infections, consequences of tumour growth, neuromuscular conditions or developmental delay in limb segment growth. The procedure has evolved significantly over the years. With technical advancement and improved safety and effectiveness, an increasing interest in cosmetic stature lengthening is observed.
While limb lengthening surgery can be beneficial, certain factors may preclude individuals from undergoing the procedure.
It is important to note that bone lengthening is a time-consuming and difficult process that takes a burden on the patient and their family life and can be hindered by a high rate of complications. It is crucial for a potential candidate to undergo a thorough evaluation by an experienced multidisciplinary team to determine the most appropriate surgical approach and to discuss the potential risks and benefits associated with the procedure. With proper patient selection, skilled surgical techniques, and diligent post-operative care, limb-lengthening surgery can yield successful outcomes, improving the functional and aesthetic aspects of the affected limb.
There are two primary methods for performing limb lengthening surgery:
Depending on the individual patient’s needs the process can involve a combination of external and internal fixation devices such as plates, cables, solid and motorised nails and external fixators.
The choice between external fixators and internal lengthening nails depends on factors such as the patient’s age, the extent of lengthening required, and the surgeon’s preference and expertise.
After the surgery and application of the distraction device, there is a 7-10 days period of latency, that allows for primary bone regenerate formation. Further, during the process of lengthening, the regenerate is distracted at a rate of 0.5-1mm daily (in 2-3 increments) until the full length is restored.
Finally, the consolidation takes place and usually lasts at least twice as long as the distraction period. For example, in order to obtain 10 cm (100mm) of bone length, it will take: 1 week of latency period, 100 days (14.5 weeks) of lengthening and 29 weeks (twice that of the lengthening duration) of consolidation time. That is at least 10 months if no complications are encountered.
If patients are worried about their level of pain, experience significant bleeding, or notice fever or redness around the surgical site, they should contact the office immediately. If assistance is needed after hours, patients can contact the hospital where the surgery was performed, and they will contact Professor Al Muderis on their behalf.
Norwest Private Hospital: (02) 8882 8882
Macquarie University Hospital: (02) 9812 3000