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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.

    Indications

    • Leg length discrepancy
    • Post-traumatic bone deformities
    • Non-healing fractures non-union & mal-union
    • Bone loss
    • Joint contractures
    • Osteomyelitis
    • 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
  • Anaphylaxis
  • Surgical Complications
  • Infection
  • Pulmonary Embolus
  • Deep Vein Thrombosis
  • Nerve/Blood Vessel Injury
  • Premature Consolidation
  • Nonunion
  • Malunion
  • Joint Contracture
  • Fracture/ Late Deformity
  • Overlengthening or Underlengthening
  • Scarring
  • Reflex Sympathetic Dystrophy(Complex Regional Pain Syndrome)
  • Loss of Function
  • Amputation

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