Limb Lengthening / Shortening Procedures

Limb lengthening and shortening procedures are surgical techniques used to correct discrepancies in limb length, deformities, or conditions affecting the bones of the arms or legs. These procedures can be applied to both children and adults, typically to address functional issues, prevent or correct deformities, or improve the overall quality of life.

Limb Lengthening Procedures

Limb lengthening involves gradually increasing the length of a bone, usually in the leg, using a combination of surgery and mechanical devices. This process is often used for conditions such as congenital limb deficiencies, growth plate injuries, or other medical conditions that result in one limb being shorter than the other.

Indications for Limb Lengthening

Congenital Limb Deficiencies: Conditions such as fibular hemimelia or congenital short femur.
Post-Traumatic Limb Discrepancy: Shortening of a limb due to fractures, bone infections, or growth plate injuries.
Achondroplasia: A type of dwarfism where limb lengthening can help achieve better proportions.
Bone Loss: Due to tumors, infections, or other conditions requiring the removal of a section of bone.

Risks and Complications

Infection: Particularly with external fixators, where pins enter the skin.
Pain and Discomfort: The process can be uncomfortable, requiring pain management.
Joint Stiffness: Particularly in the knee or ankle, due to prolonged immobilization.
Nerve or Blood Vessel Injury: Caused by the mechanical devices or surgery.
Delayed Union or Nonunion: Where the bone fails to heal properly or within the expected time frame.
Psychological Impact: The lengthy and demanding nature of the process can be challenging, especially for children.

Rehabilitation

Physical Therapy: Essential during and after the lengthening process to maintain joint mobility, muscle strength, and function.
Monitoring: Regular follow-up with X-rays and clinical assessments to ensure proper bone growth and detect any complications early.
Long-Term Care: Patients may need further surgeries for hardware removal or correction of any resulting deformities.

Limb Shortening Procedures

Limb shortening involves reducing the length of a bone to correct discrepancies. This procedure is less common than lengthening but is used in specific cases where lengthening is not feasible or when shortening is a more appropriate treatment.

Indications for Limb Shortening

Mild Limb Length Discrepancies: Where the discrepancy is small, and lengthening is unnecessary or impractical.
Disproportionate Limb Lengths: Such as in cases of hemihypertrophy (one limb is significantly larger than the other).
Congenital Conditions: Where shortening one limb can help achieve better functional and cosmetic outcomes.

Risks and Complications

Infection: As with any surgery, there is a risk of infection at the surgical site.
Nonunion or Delayed Union: The bone may heal slowly or not at all, requiring further intervention.
Limb Deformity: If not done precisely, shortening can result in angular deformities.
Joint Problems: Altered biomechanics may lead to joint pain or dysfunction, particularly in the hip or knee.