Is There an Age Limit for Limb Lengthening

Patients are often concerned about age limits when considering limb lengthening or discussing it with a loved one. Theoretically, there is no upper age limit to prevent someone from having surgery to become taller. In our trauma practice, we have corrected deformities and limb length issues in very young as well as elderly patients alike. However, the question of surgical risk must always be top of mind. Patients in their 20s- 50s are best able to handle the physical stresses of major surgery. They have also stopped growing, and by now, growth plates have closed. This means that the limb lengthening surgery should not cause stunted growth or other growth-related concerns that are often considered in adolescent patients. Finally, bone strength in this age range is at its peak.

What Is a Growth Plate, and When Does It Close?

Growth plates are small areas of tissue between bones that determine the size and shape of the bone when it eventually reaches maturity. This is what allows children and adolescents to grow. These growth plates remain open throughout puberty and begin to close between 17 and 22. Once the growth plate is closed, the patient will not grow any taller.

When we work with adolescent patients, growth plates are a significant concern. We do not want to alter growth patterns. However, checking to see if the growth place is closed is straightforward and only requires an x-ray. Of course, adolescent patients also haven’t fully matured psychologically, and the reasoning behind their decision to potentially have lengthening surgery should be discussed with Dr. Basmajian and the family.

>What Is a Growth Plate, and When Does It Close?

Biological Aging

As we age, biological degradation can begin to take hold. To understand this, we must explore how bone works. Many people believe the bone is a monolithic and unchanging structure. However, this is most certainly not the case. Bone is very much alive and cycles through shedding and regenerating constantly. After 40, more bone is lost than is replaced, leading to weaker, more brittle bones. This bone loss process can affect women more profoundly than men, especially as they progress through menopause and the hormonal changes that come with it.

As a result of the above, we suggest that patients over 55 strongly consider whether the surgical risks of limb lengthening exceed the benefits they are looking to achieve. This is not to say that surgery after this age is impossible., But it simply requires more consideration and an in-depth conversation with Dr. Basmajian

Older patients looking to have a limb lengthening surgery should undergo a simple bone density scan known as DEXA to understand if there is a risk of complications due to bone mineral loss.