Bone and Limb Lengthening Procedures

Bone deformities in your arms or legs could be the result of any number of things, including congenital disorders, developmental problems and metabolic issues. They might even stem from traumatic injuries. 

What Is Limb Lengthening?

Limb lengthening is a surgical procedure that involves straightening out deformed bones, as well as replacing missing bone.  The procedure can be minimally invasive or require an overnight stay at the hospital, depending on the severity of the condition.

The process is gradual, to ensure the bone and soft tissues (nerves, skin, muscle, etc.) can lengthen together slowly and correctly. 

What To Expect During the Limb Lengthening Procedure

During surgery, Dr. Thabet will perform an osteotomy – a procedure that cuts the bone into 2 segments. At the same time, additional soft-tissue procedures may be done in order to prepare muscles and nerves for lengthening.

Dr. Ahmed will then apply 1 of three types of orthopedic lengthening devices to the limb:

  1. Internal Device – Dr. Thabet will apply a magnetically telescopic nail inside the bone which will help the bone grow in length.
  1. External Fixator – The device is applied outside of the body and is connected to the limb using screws, pins, and wires.

3. Combined External Fixator & Nail – This takes the advantages of both implants.

Latency Phase

After the operation, it is important for the bone to rest & heal for 5-7 days. This helps prepare the limb for the lengthening and recovery process, which is made up of 2 phases: Distraction Phase & Consolidation Phase 

Distraction Phase

After the latency period, patients will adjust their orthopedic device to slowly pull apart the two bone segments. This gradual process of gently separating bones is called distraction which means “to draw away” or “pull apart”; in this case new tissue regenerates between them as they are pulled farther and farther apart — resulting in a longer limb.

The distraction process doesn’t only affect the bones, but will also affect the muscles, tendons, nerves and vessels.

The distraction phase is the most demanding phase of lengthening procedure.

Consolidation Phase / Healing Phase

Once the distraction is complete, the new bone will begin to harden & solidify, this is known as the consolidation (healing) phase. While this process can take several months, once the bone is fully healed, Dr. Thabet will be able to remove the lengthening device (external fixator device, internal lengthening device can stay).

If an external fixator was used, a cast or brace will be needed for a short time in order to give the new bone added support and protection.  If an internal device was removed, no additional support will be needed.

Physical therapy will be recommended for improving range of motion, strength and ability.

Common Indications for Limb Lengthening procedure:

  1. Limb lengthening discrepancy (LLD) due to congenital, developmental, traumatic or post infection causes.

  1. Stature Lengthening is an option for dwarf patients (Skeletal dysplasia) in which it restores body proportions, corrects the deformities & achieve functional height in society (5 feet).

Common Bones that require lengthening

  • Femur
  • Tibias
  • Humerus
  • Feet: Brachymetatarsia
  • Hand: Small bones of the hand: Metacarpals