Limb Reconstruction and Deformity Correction Surgeries

Limb-lengthening Surgery

 

OVERVIEW

Limb-lengthening surgery, a procedure that demands precision and expertise, is used to increase the length of a limb, primarily to correct the length of an unequal arm or leg. This intricate surgery can be performed on various parts of the body, including the humerus (the long upper arm bone), the radius (forearm), the femur (thigh bone) and the tibia (shin bone). Limb lengthening surgery is typically recommended for conditions of limb length discrepancy, where one limb is significantly shorter than the other.

 Your surgeon may recommend limb lengthening surgery in the following instances:

  • Growth plate disturbances. Children may experience growth disturbance to one or both limbs following trauma, infection and malignancies, amongst other causes.
  • Congenital causes may leave one limb segment longer than the other. Examples include proximal focal femoral deficiency (PFFD) or tibia / fibular hemimelia, trauma and Infections – High energy trauma and infections can cause significant limb length discrepancies and remain one of the most common causes of unequal limb lengths.

Adult causes of limb length discrepancies usually are the result of trauma and infection, as well as previous surgery.

WHAT ARE THE BENEFITS OF LIMB LENGTHENING SURGERY?

Limb length discrepancies can cause damage over time. Most patients with limb length discrepancies present with pain in their hips, knees, or lower back. Over time, unequal limb lengths cause pain in these regions due to an imbalance in posture and gait. Longstanding imbalances can cause degeneration of these joints, leading to osteoarthritis. These posture and gait abnormalities can be relieved with limb lengthening surgery, preserving your joints and improving your quality of life.

HOW DO YOU LENGTHEN THE BONE?

Bone lengthening procedures use a concept called distraction osteogenesis to create new bone. In basic terms, the short limb undergoes an osteotomy or surgical break. The surgically 'fractured' bone segments are then slowly drawn apart at a rate of 1mm a day. New bone forms between the two bony segments and eventually heals over time, restoring your limb length. During the procedure, the bony segments are fixated with either an external fixator or an intramedullary device. The device used depends on the anatomical site, bone quality, age of the patient, and several other factors.

FREQUENTLY ASKED QUESTIONS

1Are there any risks?
  • Infection
  • Joint stiffness or contracture
  • Non-union (bones not healing)
  • Mal-union
  • Nerve damage

All surgery has risks or complications. It’s important to discuss these risks with your specialist to weigh up the risks versus the benefits of the surgeries

2How long does the lengthening procedure take?
The time for a limb to heal after lengthening surgery depends on several factors. The most important factor is the size or degree (cm) that the bone needs to be lengthened. Limb lengthening generally takes several months to heal.
3Can limb lengthening be used to make me taller?
Yes: cosmetic limb lengthening is the process whereby both lower limbs are lengthened to achieve a greater height. It is very important to speak to an experienced limb reconstruction surgeon before undertaking surgery to understand the risk factors involved.