What is Limb-Lengthening Surgery?

Lengthening surgery is a device-assisted orthopedic surgery that allows the bone length to be gradually extended in the lower or upper leg or both, with the method we call distraction osteogenesis, which is based on the basic principle of self-completion of the cut bone.

Why is Limb-Lengthening Surgery Performed?

Being below the average height can turn into a situation that makes social life difficult, and the primary use of leg lengthenin surgeries is to overcome this socio-psychological barrier/health problem. In addition, male or female individuals who have aesthetic desires such as looking taller, although not below the average, may apply to orthopedic surgery for height increase surgery. 

Lengthening surgeries arise with the use of surgeries for the treatment of dwarfism, which are performed to eliminate orthopedic disorders caused by functional length differences caused by arm-leg length inequality, which we call limb height inequality.

What is Limb Inequality?

 It is the medical term used to express the difference in height between the legs or arms. Shortness of the lower extremity and length of the legs are meant differently and thanks to the same techniques and devices used in lengthening surgeries, it is possible to treat the inequality between leg lengths. 

Who Can Have Limb-Lengthening Surgery?

Lengthening surgeries, which were previously performed only for health reasons, are now applied within the scope of cosmetic orthopedics for aesthetic reasons. 

• Adult men and women of below-average height with closed growth plates
• Children older than 4 years with symptoms of dwarfism
• Healthy adult women and men who are not satisfied with their height and/or want to appear taller, although they are not below average
• Children and adults with limb inequalities (disparities after previous fracture or illness)

Types of Lengthening Surgery

Advances in orthopedic surgery of developing medical technology have also reflected positively on lengthening surgeries, providing diversification of device and surgery types. Thus, there is an advantage in choosing the most suitable method for the age of the patient and the purpose of the height increase surgery.

In addition, the cost of these methods is different and it creates alternative lengthening surgery prices for patients who want to have lengthening surgery, which is another important advantage.

Devices and methods currently used in lengthening surgeries that work with the basic principle of gradual lengthening of the bone are evaluated in three main categories: 

• Ilizarov Circular Fixator/External Fixation (external extension only)
• Intra-Bone Motorized Nail Technique/Internal Fixation (magnetic nail)
• Combined Length Lengthening Surgery/Length Lengthening Surgery Using Internal and External Fixation Together (lengthening with an external apparatus over the nail)

How is the Limb-Lengthening Surgery Performed?

Lengthening surgeries can be performed under general or spinal anesthesia. The operation time takes 1.5/2 hours depending on the technique to be used. Lengthening is usually performed by lengthening the shin or thigh bone. In some cases, it is possible to lengthen both the shinbone and the femur.

According to the preoperative planning and the method to be used, the bone is reached with small incisions and the bone is cut transversely. Then, the stabilizers that will provide the gradual lengthening of the cut bone are fixed to the leg.

After that, it constitutes the second stage of the lengthening surgery. In order to achieve an average of 1-millimeter bone lengthening every day, the cut bone is removed from each other with the help of the device. Depending on the trauma, the body is expected to be stimulated to repair the bone. The body produces tissue to close the gap between the receding bones (lengthening time + 1.5 fold the lengthening time). In the end, lengthening of the cut bone is obtained.

After Lengthening Surgery

The lengthening procedure and the post-process appear differently in adults and children. Since the growth plates are active in children, the targeted lenghtening is achieved in a shorter time, while the use of the device takes longer in adults.

It takes 6 months to 1 year in adults for the device to come off and the bone to heal completely. After the device is removed, the process continues with physical therapy and rehabilitation applications.

The pain after lengthening surgeries is not very severe, but it would not be correct to say that it is a painless process.

The bone tissue formed after the lengthening surgery is as strong as the other bone tissue of the body and is in a structure to be used without any problems throughout life. The risk of fracture is equal to the risk of fracture of the untreated leg bone.