Limb lengthening is a surgical procedure to make the arm or leg bones longer. It is a gradual process so that the length of bones, surrounding muscles, tendons, and ligaments increases slowly. It is a time-consuming procedure that usually requires several months.

Limb lengthening surgery is performed on: 

• Humerus (Upper arm bone)
• Radius/ulna (Forearm bones)
• Femur (Thigh bone)
• Tibia (Shin bone)

What Does Limb Lengthening Surgery Treat?

A limb lengthening surgery typically treats differences in the length of arms or legs. However, it can also treat conditions that can cause irregular bone growth. Limb lengthening surgery is recommended for those who have:

• Benign bone tumor on a growth plate
• Congenital femur deficiency
• Cerebral palsy
• Growth plate fractures
• Osteomyelitis
• Skeletal dysplasia
• Hemihypertrophy

Tests Before Limb Lengthening Surgery

The healthcare professional performs various tests to assess the patient’s suitability. Different tests and assessments include:

• Length Differences Assessment: Visual inspection of the limbs for differences in length and alignment.
• Gait Analysis: To check the cause of any gait abnormality.
• X-rays: To measure the bone length and assess the overall bone structure.
• CT Scans: To get a more detailed view of the bone structure and assess the surrounding soft tissues.
• Blood Tests: To check the overall health of an individual

How Does Limb Lengthening Surgery Work?

The procedure takes place in four steps:

Surgery

In this stage, the doctor will cut the bone into two pieces and create two separate segments. It is done in a very specific way to preserve blood flow. This procedure is called osteotomy. A limb lengthening device is attached to the two segments of bone. The orthopedic limb lengthening device, which is inserted into the bone, is called an internal device, such as a Precice nail. External fixators, such as the Taylor Spatial Frame or the Ilizarov devices, are fixed on the leg’s outside.

Latency Period

Once the surgery is done, your bones are allowed to rest for 5-7 days to heal properly. During this time, the doctor won’t lengthen the bones manually. 

Distraction

During this stage, the two ends of the bones are gradually separated so that new bone forms in the space between them. This new bone is known as regenerated bone, which increases the overall bone length. This stage typically takes up to 2 months as the adjustment is very small, usually between 0.75 millimeters and 1 millimeter a day. Throughout this stage, careful monitoring of the bone and surrounding muscles and tissues is crucial to check for any signs of possible complications. 

Consolidation

It is the final stage when the new bone begins to get thicker, harder, and solid, which requires 2-3 months. When the limb has reached its planned length, the natural healing process of the body continues to fill the gap with new bone. It is recommended to wear a brace for 3-4 weeks when the external fixator is removed, while no cast or split is applied when the internal device is removed. Physical and occupational therapy are important to maintain joints and muscle mobility around the lengthening bone.

Recovery After Limb Lengthening Surgery

The lengthening may be complete, but healing is still in progress. Below are some tips to manage pain and discomfort:

• Gradually increase your activity level and build up to your daily schedule
• Take regular breaks for resting and stretching to reduce pain and discomfort
• Use pain medications to manage pain
• Avoid any strenuous activity
• Use crutches or a walker to reduce pressure on the lengthened leg
• Consider physical therapy to improve flexibility

Full recovery can take several months, and it is vital to follow the advice of your healthcare professional for proper healing.

How Much Can Each Bone Be Lengthened?

During each lengthening procedure, a bone can be lengthened 2 inches. If someone has a limb length difference of more than 2 inches, they need to undergo the procedure more than once over the years.

Legs can be lengthened up to 25 percent, and arms can be lengthened up to 40 percent of their original length at once.

Advantages

The success rates are high with positive outcomes. Below are the advantages of the procedure. It can improve:

• Flexibility
• Gait
• Strength
• Range of motion
• Complications of leg length difference

Risks

Limb lengthening surgery also carries several risks, such as:

• Nerve damage
• Blood clots
• Infection
• Joint stiffness
• Bone healing issues
• Walking difficulties
• Asymmetry or disproportion

Various factors can increase the risk, such as age, bone health, diabetes, or autoimmune system disease, the type of lengthening device, and the length of the lengthening.

It is vital to talk to your healthcare provider about the possible risks and complications before undergoing limb lengthening surgery.

Find out the detailed limb lengthening surgery cost in India and choose the best treatment plan that suits your needs and budget.

Bottom Line

Limb lengthening surgery can be a life-changing procedure for those who have bone growth issues. Thanks to advanced devices and the best medical care, the process has become easier and safer than before. With proper care and management, one can have an active life with their lengthened arm or leg.