A discrepancy in leg length will usually become obvious to parents as they watch their child grow and begin to crawl and walk. Some children are born with legs of different lengths. In other cases, illness or injury causes a discrepancy in limb length to develop over time. While a slight difference in leg length may not cause symptoms, a significant difference can cause a noticeable limp and make it difficult for a child to run and play.
Medishala talked to Dr Anil Kumar one of Patna’s top Orthopaedic Surgeon currently practicing at Patna Ortho Clinic situated at
MIG-126,Doctors Colony, Kankerbagh, Patna about Limb lenghthening surgery and here is what he has to say:
Limb lengthening is achieved using the body’s own capacity to create new bone as well as the soft tissues, ligaments, blood vessels, and nerves that surround and support it. The process begins with an operation called an osteotomy in which the orthopedic surgeon cuts the bone to be lengthened. The limb (usually the upper or lower leg) is then stabilized using one of several different external and/or internal fixation devices or frames
How limb lengthening procedures is carried out?
The process begins with an operation called an osteotomy in which the orthopedic surgeon cuts the bone to be lengthened.
Osteotomy and placement of most fixation devices may be done using epidural anesthesia—the same type of anesthesia that many women receive during childbirth—so that they may be awake during their surgery if they so choose. The average hospital stay is two days. The procedure involves no large incisions or bone grafts
This surgery involves mounting an external fixator on the limb. The fixator can lengthen a short limb, correct a deformity or both.
There are two main types of external fixator:
- circular rings that go around the outside of the limb
- a rail (straight bar) along one side of the limb.
The Distraction Phase:
The bone that has been cut is very gradually pulled apart, in a process that promotes distraction osteogenesis or new bone growth at the site of the osteotomy. Continued growth of new bone tissue is accomplished by adjusting pins in the frame four times a day, ¼ millimeter with each adjustment, for a total of 1 millimeter a day. As the space between the ends of the bone opens up, the body continues to produce new tissue in the gap until the desired length of bone has been generated. Additional adjustments may be made to the fixation devices to correct any deformity that may be present, such as a misalignment of the bone resulting from trauma. Early on in this phase, patients learn to walk with the aid of crutches.
During the second phase of treatment the bone consolidates and heals. The patient gradually puts more weight on the affected limb, and starts walking without crutches
Recovery and Rehabilitation
Recovery time from the limb lengthening procedure varies among patients, with the consolidation phase sometimes lasting a considerable period—especially in adults. As a general rule, children heal in half the time as it takes for adult patients. For example, when the desired goal is 1 and one-half inches of new bone growth, a child will wear the fixation device for three months; an adult will likely take 6 months to complete the process.
Eligibility for Limb Lengthening Surgery
Orthopedic surgeons in the Limb Lengthening Service obtain a special series of x-rays to precisely assess and confirm each diagnosis.
Limb lengthening surgery can be done safely and effectively in both children and adults–including those in their 20s, 30s, 40s, and even 50s. In pediatric patients, the orthopedic surgeon takes special care to avoid injuring the growth plate, and both normal growth and distraction osteogenesis continues during recovery
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How much does it cost?
The cost for limb lengthening is around (Rs 1.5lakh to Rs 2.5 lakh) , a growing number of people in India are going in for limb–lengthening surgery.