Limb lengthening or Reconstructive operations
About the Treatment
Limb lengthening and reconstruction techniques are used both for children & adults to replace missing bone and to lengthen or straighten deformed bone segments either due to birth defects, disease, or injury
Recently these procedures have gained popularity as a cosmetic procedure to increase the height of a person.
It works on the principle of distraction osteogenesis in which a bone that has been cut during surgery is gradually pulled apart, leading to a new bone formation at the site of the lengthening. The process may take several months to produce the outcome.
- Leg length discrepancy
- Post-traumatic bone deformities
- Non-healing fractures non-union & mal-union
- Bone loss
- Joint contractures
- Missing bone parts - following trauma, infection
- Increasing height of a person by 2 to 5 inches
- Careful clinical assessment of the patient is done.
- Appropriate tests are done.
- In discussion with the patient and the relatives realistic goals are set.
- Likely duration of the surgery is 2 -3 hrs.
- Deformed bone is broken by surgeon
- Ilizarov fixator is attached to ends of the broken bone
- Ilizarov fixator consists of rings and rods
- Rings surround the limb, pair of rings above and below the fracture site
- Rods are passed horizontally through the rings passing through bone
- Rods also run vertically between the rings
- Rods are inserted by making small incisions in the skin
- The patient may need to stay in the hospital for 3 to 7 days post-surgery.
- The actual lengthening and straightening of the limb shall start 1-2 weeks after the surgery.
- The Limb is slowly stretched by slowly increasing the height between the rings across the fracture site.
- Maximum rate of stretching is about 1 mm per day
- Duration of the procedure is about 2 to 3 months depending upon the deformity correction needed.
- The patient is bedridden for 3 - 4 months
- Proper care of the wound and physiotherapy required for 5- 6 months to resume normal living.
- Regular follow-up for 3 -4 months is required
- Once the desired outcome has been achieved the apparatus is left in place to allow the new bone to harden and mature.
- After that frame is removed & a cast or brace may be applied for another month or two for further protection.
- Continuous follow up with the basic investigation is required to achieve the best outcome.
- Anaesthetic Complications: stroke or heart attack
- Surgical Complications
- Pulmonary Embolus
- Deep Vein Thrombosis
- Nerve/Blood Vessel Injury
- Premature Consolidation
- Joint Contracture
- Fracture/ Late Deformity
- Overlengthening or Underlengthening
- Reflex Sympathetic Dystrophy(Complex Regional Pain Syndrome)
- Loss of Function
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