Limb lengthening surgery utilizes the body’s natural healing potential to lengthen bones. Common bones that are lengthened include the tibia, femur, humerus, metatarsal, and metacarpal bones.
This lengthening distraction process is accomplished by bone osteotomy and temporarily attaching an internal lengthening device or external fixator to the desired bone.
Activating the device will slowly stretch the bone and limb stimulating growth of the tissues and allow your body to grow new bone. Limb lengthening is done to treat leg length discrepancies or to increase stature.
Limb Length Discrepancy Before and After
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Limb Length Discrepancy Before and After
Conditions
The need for limb lengthening surgery can be due to a variety of issues including:
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Loss of length from trauma, Congenital conditions, Growth plate injuries
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Short stature
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Bone defects
Treatment Options
Internal lengthening nails can be used to grow bone by slow extension using an external magnet. After surgery the bone is allowed to rest for a few days (latency period) while stem cells collect at the osteotomy site. Lengthening progresses at 0.5mm – 1.0mm per day based on the quality of the new bone formation. Once the bone has achieved the desired length it is allowed to consolidate. When the bone has fully healed the hardware is removed.
External fixators are used to lengthen bone and simultaneously correct deformities. These devices are very reliable and have been in use for many years. In most cases, patients would have to manually adjust their fixators according to a set schedule. However, there are now computerized versions that self-adjust in micro-increments multiple times a day.
Limb Lengthening - Femur Growing Over Time
Recovery
Surgery is performed at the Hospital for Special Surgery in New York City. Dr. Fragomen personally performs all of the procedures and is supported by a professional surgical team.
Patients are admitted to the hospital after surgery for an average of 2 nights where they will receive multimodal pain control from the HSS pain team and physical therapy for crutch training. Patients can expect to be on crutches during the lengthening period and the early part of the consolidation period.
Once the osteotomy site has healed patients may resume unrestricted physical activity. All hardware is removed in an ambulatory setting.
Medical Questions
Dr. Fragomen: fragomena@hss.edu
Erica Lenihan, RN: lenihane@hss.edu
Zac Edelman, PA: edelmanz@hss.edu
Eric Lau, PA: laue@hss.edu
Scheduling and Insurance Inquiries
Patient using an external magnet to lengthen internal rod
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