What Is Limb Lengthening Surgery?

Limb lengthening or height lengthening is the process by which the arms or legs, but usually the legs, are extended using a process known as distraction osteogenesis. In other words, the bone is cut and pulled apart slowly enough to allow the body to regenerate and fill in the gap with new bone. Consider it much like building a bridge but using the body’s own repair capabilities to close the gap. Patients with congenital deformities, trauma from car crashes or other accidents, or those who wish to change their height for cosmetic reasons can benefit from a procedure that today is safer and more effective than ever.

One of the most satisfying parts of the limb lengthening process is the collaborative nature of the treatment plan between Dr. Basmajian and his patients. Of course, patients play the most significant role in the result of the procedure, from start to finish. Before the surgery, Dr. Basmajian will consult with patients to understand their needs and desires and develop a treatment plan to achieve them best. Even after the surgery, we work together to ensure that the bone is distracted at just the correct rate to keep the surgery on track. With a collaborative effort, results can be just what the patient wished for.

How Limb Lengthening Surgery is Performed

You may wonder how the procedure works and should be happy to know it is very straightforward. The procedure can be performed in an outpatient surgical center and patients can be discharged within 24 hours and do not have a hospital stay. The entire procedure is performed under general anesthesia, and patients will not be aware of any part of the surgery.

Regardless of the technology employed, the bone needs to be cut in a surgery known as osteotomy. At this point, an external or internal guidance system is used to distract or pull the ends of the bone away from each other.

External Fixation

External fixation involves a medical device worn on the outside of the limb. Some devices encircle the limb, while others run down the side. Regardless of the design of the fixator, it is held in place using pins attached to either side of the bone that is being lengthened. Patients separate the bone slowly, by hand, each day. For cosmetic applications, this is not an ideal option as the device is obvious, there is a higher risk of complications, and there is room for error due to the manual nature of the distraction. These days, the procedure is performed using internal lengthening and magnetic technology, which you can read below.

Precice System (Internal Lengthening)

A specially made stainless steel rod known as the Precice Nail (an intramedullary nail) is inserted into the hollow center of the bone. This nail is the definitive guidance tool during the lengthening process, ensuring the bone remains in line as it is pulled apart. An automated external device, placed over the leg daily, precisely guides implanted magnets that distract or open the bone slightly, usually by about 1 millimeter per day.

Recovery After Limb Lengthening

At Home

Once the patient has gone home, the lengthening process begins. It is important to remember that lengthening must be performed at the right speed to reduce the risk of under or over-correction. An electronic system guiding the elongation certainly does help, but patients must remember to activate the device daily.

Back To Normal

The rule of thumb is that you need one month to lengthen 1 inch and two additional months to allow the bone to set and return to its normal strength. If you want to add two inches, it will take approximately six months, while 5 inches will take about 15. While this may seem tedious, the slow and gradual distraction allows for a better outcome. Keep in mind that with the internal device, once lengthening is completed, patients are living a fairly normal life while the bone is regaining its strength.

Once the appropriate lengthening has been achieved, the external fixator is removed (if external fixator is used), which is a short recovery period for the wounds to close. While the intramedullary nail can be removed, doing so is primarily up to the patient. The rod is designed for the option of permanent implantation and, as such, can be left in the bone in perpetuity without adverse effects. Leaving the nail in the bone also avoids a second surgery and anesthesia event for the patient. This is a conversation each patient will have a Dr. Basmajian when the time comes.