Limb lengthening surgery is usually done to correct the legs that are uneven in length. For instance, if the person has an abnormally short leg compared to the other leg because of injury or conditions at birth, then doctors can advise limb lengthening surgery.
Doctors usually do not recommend this procedure unless there is a difference of at least 2 cm between the lengths of the legs of the patient. The doctor can also advise other treatments, like wearing a shoe insert to remove limb length differences. In many cases patients do not experience symptoms until the difference in the length of their legs is at least 4 centimeters.
Limb-lengthening surgery is common in young adults who are aged between 18 to 25 and near the end of bone growth. However, the procedure can be performed in older adults in rare cases as well.
Doctors will also typically advise limb-lengthening surgery for both limbs in the cases of dwarfism, which is a medical condition in which people are short in stature because of their genes or medical reasons like achondroplasia, a genetic condition which is the most normal type of short-limbed dwarfism.
Before the surgery
The doctor will give important instructions regarding preparation for the surgery and the instructions can include:
During the surgery
Surgeons can perform limb-lengthening surgery in one of two ways: by applying pins and a frame outside the leg known as an external fixator or by placing a nail in the bone known as an intramedullary nail. The nail can be lengthened over time to assist bone growth and extension.
General anaesthesia is administered to the patients in both the methods of this surgery.
The most common type of procedure involves the following:
After the surgery
The doctor will give instructions to the patients regarding the levels of activity that they can perform in the period after the surgery. Sometimes, the patient might be required to stay in the hospital for several days after surgery for observation and physical therapy.
The majority of the patients are restricted to light activities and may use crutches to move in the days following the procedure. The doctor will also recommend the patients to take vitamin D and calcium supplements to assist bone growth.
Some people might have to wear splints and braces to assist the healing cycle. The doctor also performs "distractions" which is the process of moving the fixator or the nail to lengthen the legs. The doctor will begin the procedure several days after the surgery and patients may have many additional appointments with the doctors for adjustments.
As patients continue to recover, the doctor can increase the activity levels of patients to include full weight-bearing movements. The doctor can also advise physical therapy to increase activity levels.
Since the limb-lengthening procedures are invasive, there are risks involved and they include reactions to anaesthesia, bleeding, and infections, especially at the sites where the pins are placed.
There is also a risk that the surgery will be unsuccessful due to the improper healing of bones. Some patients may also recover in a manner where the bones are no longer straight.
Limb lengthening surgery can help correct differences in leg length and thus correct the resultant adverse side effects, and can also address cosmetic concerns. Patients must be selected after proper due diligence for this procedure, and the doctors will also carefully examine patients, their conditions and overall health before advising the patients to undertake this surgery.
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