Limb Lengthening surgery is an operation that provides lengthening of the bones in the legs which done by the orthopedic surgeons. These surgeries are based on the body's ability to create its own new bone and surrounding tissue.
These kind of surgeries can be performed for length inequalities, congenital bone defects and also aesthetic concerns. Generally, 5-8 cm extension is preferred. Greater lengthening may be possible with lengthening both in the lower and upper leg bones, but it should be known that this is a condition that increases the risk of complications. The lengthening process takes place within months according to the amount of extension, while the total duration of treatment may require an average of 1-2 years.
Genetic and hormonal factors, chronic diseases, and traumatic injuries can cause shortness, leg length inequalities or bone deformities. These situations can cause physical restrictions and problems, as well as can cause social and psychological effects. Many people are also prefer to increase their height for aesthetic concerns or purposes.
It is desired to have reached bone maturity in length extention surgeries. The natural growth process in children and adolescents takes place with growth plates on the bone tips. These plaques loose its growth ability and close at an average of 17-21 years old and reach their final height. Since the development of new bone tissue and healing will slow down as the age progresses, the most suitable age range for lengthening surgeries is 20-45 years. However, in cases such as dwarf treatment, treatment is started earlier in childhood, according to the bone structure.
Healing process depends on the body's capacity to form its own bone and surrounding tissue. No-smoking, life standards and being healthy are important accelerating factors of healing.
Limb Lengthening surgery is mostly done by lengthening the upper and lower leg bones, known as the femur and tibia.
Firstly the bone to be lengthened is with the procedure known as osteotomy in during the operation. The leg is fixed using A special methods and devices (external or internal fixing devices). Then, the two tips of the cut bone are removed from each other gradually and continuously. After the operation patient continue to the extension process approximately adjusting 1 mm per day by using special device. Extension is stopped when the planned length is provided.
Later, soft tissues, ligaments, blood vessels and nerves are formed in the space formed between the bones and the new bone tissue and it becomes hardens and solidifies.
Limb Lengthening Treatment is a process that requires time, patience and precision. It may take 4-6 months for the bone to heal and stabilize in avarage extension treatment. Patient should walk with the help of a support such as crutches in the beggining of the recovery period. After then patient starts to give a little more weight to the treated leg and walk without support. Treatment should be supported with physiotherapy programs for the development of movements and functions. The external or internal fixation device which is used before is removed from the leg when the treatment ends.
There are three methods are used to fix the leg and provide the extension process between the Bones in Limb Lengthening Surgeries.
External Method; external fixators are used, which are fixed on the outside of the leg by pins or wires that connect to the bone sections.
Internal Method; internal fixators such as metal nails, are used, which are placed inside the bone. These nails are lengthened by adjustments made by the patient from the outside with a remote control. There is no apparatus attached to the outer part of the body.
Combine Method; these two methods can be applied in same time.
Precice is a limb length extension system that specially designed for lengthening the thigh and shin bone in extension surgeries which consisting of intramedullary nails and screws placed inside the bone. There are no any seen parts worn on the outside of the body. An external remote control is used to extend the Precice nail daily. It can also be used shorten it if necessary.