| Limb Lengthening and Reconstruction | | | | |
| Techniques | | | | Children and adults can be appropriate |
| | | | candidates for the procedure. Children with |
| 16th November 2006 | | | | congenital deformities such as fibular |
| | | | hemimelia, congenital short femur and |
| Author: Chris Maylor | | | | hemiatrophy will often have unequal leg |
| | | | length and this may be associated with |
| Limb lengthening and reconstruction | | | | deformity. Many adults have had this |
| techniques can be used to replace missing | | | | condition since childhood and have developed |
| bone and lengthen and/ or straighten deformed | | | | back pain and hip arthritis from the leg |
| bone segments. The procedures may be | | | | length discrepancy. Growth plate fractures |
| performed on both children and adults who | | | | and bone infections in children can cause |
| have limb length discrepancies due to birth | | | | stunting of growth that results in |
| defects, diseases or injuries. The limb | | | | discrepancy. |
| lengthening and deformity correction process | | | | |
| works on the principle of distraction | | | | Following trauma, bones can heal in a |
| osteogenesis. This is a revolutionary concept | | | | shortened and deformed position (mal-union). |
| that reverses the long-held belief that bone | | | | Sometimes the bone can even remain unhealed |
| cannot be regenerated. In this process, a | | | | (non-union). Limb lengthening procedures |
| bone that has been cut during surgery can be | | | | address all of these issues. We have been |
| gradually distracted (pulled apart), leading | | | | able to successfully correct large |
| to new bone formation (osteogenesis) at the | | | | deformities and equalize limbs with |
| site of the lengthening. In this way, bone | | | | discrepancies of several inches. A segment of |
| segments can be lengthened by 15 to 100 | | | | bone can be missing after a bone tumor, bone |
| percent of their original length. We use a | | | | infection or severe fracture. We can |
| variety of techniques, including the use of | | | | transport new bone to fill in this defect. |
| monolateral (one-sided) and circular external | | | | |
| fixation devices, to correct angular | | | | Short stature can be very disabling in |
| deformities as well as limb length | | | | patients with dwarfism, for example. We can |
| discrepancies. With these procedures, we | | | | lengthen both legs simultaneously to increase |
| provide opportunities for individuals who | | | | stature. We have been able to lengthen |
| previously had no treatment alternatives. | | | | achondroplastic dwarf patients 12 inches in |
| | | | the legs and five inches in the arms. This |
| The regenerated bone is normal and does not | | | | allows them to function more independently |
| wear out. The muscles, nerves and blood | | | | and be able to reach the telephone, toilet |
| vessels grow in response to the slow stretch | | | | and gas pedal, for example. |
| like they do during a growth spurt or in | | | | |
| pregnancy. The actual procedure is minimally | | | | Young adult patients with leg deformities are |
| invasive and requires only one or two nights | | | | at risk for developing arthritis as a result |
| in the hospital. Patients aren't in much pain | | | | of their malalignment. These same techniques |
| since the distraction is so gradual and | | | | can be used to correct severe deformities |
| patients can continue to walk during the | | | | safely and avert the need for joint |
| treatment. | | | | replacement. |