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