Will Limb Lengthening Hurt?
When we talk about manipulating bone, we often think about breaks or fractures, which can be extremely painful. However, the process by which we cut the bone and ultimately begin to pull it apart to increase height is far more precise and controlled. Today, technology has afforded us an elegant solution for cutting bone. Our modern devices cut from the inside of the bone outward, involving less nerve and muscle tissue in the process. The cut is precise, and the patient is under general anesthesia. Once the intramedullary rod has been inserted and the patient is recovering from the surgery, they’re often surprised at the discomfort level:
- First, the minimally invasive nature of the intramedullary nail means that we have fewer surgical wounds than prior external fixation would require
- Then, we use a long-lasting local anesthetic that can keep the pain at bay for the next few days. Of course, different patients will have varying pain thresholds, so some patients will feel more discomfort than others. Usually, patients can manage discomfort with over-the-counter acetaminophen and alternating with ibuprofen. Narcotic pain medication is needed sparingly, if at all.
Of course, you may also be worried about any pain or sensation you may feel as the leg is being lengthened. The lengthening process is precise, and we discuss daily distraction (adding length) in millimeters. This is because the limb lengthening process is purposefully slow to ensure the effectiveness and safety of the procedure. Most patients feel some discomfort in the first week or two during the lengthening process as the body adapts to this new normal. Eventually, patients will feel no pain as the limb is pulled apart at approximately 1 millimeter a day. This is not to say there won’t be soreness. As we lengthen the limb, muscles and tendons will tighten. However, with proper postoperative care, time, and physical therapy, this discomfort resolves itself quickly.
