Limb Lengthening Surgery

What is leg lengthening?

Leg lengthening is a surgical operation which corrects a leg length discrepancy by stimulating new bone to grow in the shorter leg.

How does leg lengthening work?

Bone has a remarkable ability to naturally regenerate after a fracture or after it is surgically cut. This ability is known as osteogenesis.  Leg lengthening surgery takes advantage of this capability of the bone, and works by the surgeon cutting the bone and separating the two ends, allowing new bone to grow in between lengthening the leg. This process is known as distraction osteogenesis. Limb-lengthening can be carried out in the thigh (femur) or lower leg (tibia).

The 4 key stages of leg lengthening surgery are:

  1. Osteotomy - The bone is cut and divided into two sections.
  2. Distraction - The two ends of bone are seperated at a controlled rate approximately 1mm per day, known as distraction, using specialised surgical equipment (i.e. external fixators or internal nails).
  3. Osteogenesis - New bone forms in the space between the two ends of separated bone.
  4. Consolidation - Bone and soft tissue consolidate and heal.

What types of leg lengthening surgeries are there?

Leg lengthening surgery can be performed using an external fixator or an internal lengthening nail, and the decision to use one over the other should be done in discussion with your surgeon.

External fixators (i.e. Ilizarov frame or TSF) are a metal cage built on the outside of a limb and is connected to the bone with pins, screws and wires. We can adjust the external fixator to gradually and carefully lengthen, and straighten a shortened or deformed limb. With this option, the external fixator apparatus must remain on the leg for the entire time of the procedure, however the advantage is that you can fully weight bear while it is on.

Internal lengthening nails are mechanical internal nails which are inserted into the bone marrow cavity of a bone, and can be lengthened to gradually increase the length of the bone.



How long does it take to recover from leg lengthening surgery?

Recovery time from the limb lengthening procedure varies among patients, in particular the consolidation phase can last a considerable period of time. In general, children will recover much quicker than adults.

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