During your consultation, Dr. Basmajian will review your medical history and perform a physical examination, which may include imaging. The goal is to best understand the results you wish to achieve, determine any limitations to daily activities and function that the limb lengthening procedure will improve, and develop expectations for your procedure and recovery.
Lim lengthening surgery is customized based on each client’s needs and medical exam. Depending on the degree of lengthening targeted and the device used, Dr. Basmajian will make small incisions over the femur and/or tibia. He will divide the bone and place the intramedullary nail (rod) inside to guide the lengthening process. Most incisions will be closed with surgical glue and tape.
There are risks involved with all surgical procedures, including bleeding, wound infection, and nerve damage. These are mitigated by employing a very experienced surgeon like Dr. Basmajian. Limb lengthening also comes with the risk of hardware failure, though this is very rare. You must follow all post-operative instructions to minimize potential complications.
Day 1: Leave all bandages in place. Keep the area clean and dry. If bathing, protect the bandaged area from getting wet. As the internal fixation device will hold everything in place, no casting or immobilization will be necessary.
Day 2 (and beyond): Remove the overlying bandage but leave the surgical tape over the incision sites. Shower with soap and water, but do not scrub the incision area. Pat dry and leave open to air. Do not apply lotions or creams to the site. It needs to remain clean and dry. Do not submerge the area in standing water, such as in a bathtub or pool, until the incisions have healed, which takes about two weeks.
Please call Dr. Basmajian or one of our nurses if you notice drainage from the incision sites. They will direct you further based on the look and amount of fluid. Similarly, a foul smell from the incision sites, worsening pain, a persistent fever, and worsening redness should be seen by a doctor immediately.
Most patients will not feel significant pain after their procedure but will need to manage some mild pain and discomfort from the incisions. Tylenol (acetaminophen) is usually sufficient to manage the pain. During the lengthening process, most patients do not feel more than slight discomfort as the bones are only pulled apart by a very small amount during each session.
The internal device will keep the bones stable. There are no restrictions regarding position or motion of the extremity at rest (such as when sleeping).
Depending on the device used, the extremity may have weight-bearing restrictions.
If restricted to touch-down weight bearing, you may rest the foot on the floor but not put weight on it (such as to transition or pivot to another position). You will use a walker or crutches to keep weight off the extremity until your surgeon directs you otherwise.
The lengthening process will take time as the bone is slowly pulled apart, allowing it to grow toward the preferred end goal. You will be shown how to place and activate a lengthening device to ensure precise and gradual limb lengthening. You must repeat this procedure a few times a day, and these lengthening sessions will last three to seven minutes. The machine does all the work and is preprogrammed with precise guidelines. You need not worry about bone over-lengthening as the device is set to maintain appropriate progress.
We will follow up with you regularly during the limb lengthening process. X-ray imaging will be taken at two weeks and every month after that to monitor limb lengthening progress. If you are visiting from out of town, we will work with your local medical team to coordinate your care.