Limb lengthening surgery

What is limb lengthening surgery?

Limb lengthening surgery, sometimes referred to as leg lengthening surgery or height surgery, is a procedure used to increase height, improve walking balance, and address appearance concerns. Limb lengthening may be used to correct differences in leg lengths. These differences can occur because of birth defects, traumatic injuries, cancer, or other conditions that change bone alignment or growth. Limb lengthening also serves a more cosmetic purpose: to make you taller. The procedure can add up to six inches of height.

People who undergo limb lengthening report the following benefits:

  • Improved comfort: The procedure can reduce pain or discomfort caused by uneven limbs, improving mobility and making everyday activities easier.
  • Balanced gait and walk: By correcting the difference in leg lengths, the procedure helps people walk more evenly, reducing limping or unsteadiness.
  • More proportional height: Limb lengthening can improve a person’s overall height, making their legs or arms appear more proportional to the rest of their body.
  • Better psychological outlook: Limb lengthening can boost self-esteem and confidence, especially for those who feel self-conscious about their height or physical differences.

Penn Medicine’s Orthoplastic Limb Salvage Center has highly skilled orthopaedic specialists who can correct and improve limb length inequalities with modern, streamlined techniques. We’re one of the few centers worldwide who use an internal magnetic extending rod and external magnet for limb lengthening. This process allows for less scarring and greater comfort than the protruding cages and fixtures used in traditional procedures. People seeking solely to increase their height also have the option to explore elective surgery (surgery that is not covered by insurance) through Penn Medicine’s Total Aesthetic Limb Lengthening & Extremity Reconstruction (TALLER) program.

How the limb lengthening procedure works

Limb lengthening surgery involves breaking the femur or tibia (thigh or shin bones) through small incisions in the leg. A magnetic rod and pins are placed inside the bone to allow controlled lengthening over time. An external magnet activates a gear in the rod, which slowly increases the length of the bone. This advanced method avoids the need for older external devices.

After surgery, patients are taught how to adjust the rod to lengthen the bone, typically by ½ to 1 millimeter a day, about one inch per month. As the bone grows, the muscles, tendons, skin, and arteries also stretch.

Who is a candidate for limb lengthening?

Limb lengthening surgery may be helpful if you have specific clinical conditions affecting your limbs, or if you are seeking to increase your height for aesthetic reasons. Whether you are a clinical or aesthetic candidate, limb lengthening can be life changing, offering improved mobility, body symmetry, and self-esteem.

What happens during limb lengthening surgery

During limb lengthening surgery, you should not feel pain because you will receive either regional anesthesia, which numbs the area of your body that will be operated on, or general anesthesia, which puts you to sleep. Pain levels during and after surgery can vary based on your individual pain tolerance and overall health. Your Penn Medicine care team will create a comprehensive pain management plan tailored to you.

In the operating room:

  • The surgeon will make small incisions in your leg and cut through the bone to be lengthened (usually the femur or tibia), taking care to avoid damaging surrounding tissues.
  • A telescoping rod is inserted into the bone marrow and secured with screws. This rod will be gradually extended to increase the length of the bone.
  • Once the rod is properly positioned, the surgeon closes the incisions with stitches or staples.

After the procedure:

  • There is a short waiting period, typically a few days, to allow initial healing before the lengthening phase, called “distraction,” begins.
  • During distraction, you’ll use a magnetic handheld device to rotate the gears of the rod from the outside of your leg each day. This causes the rod to extend slightly.
  • You’ll extend the rod by ½ to 1 millimeter each day for up to three months depending on desired length, allowing new bone to grow in the gap created by the lengthening process.
  • Physical therapy usually begins during the distraction phase. As the bone lengthens, muscles, tendons, and ligaments can tighten, so exercises are needed to prevent stiffness. Physical therapy will also help you begin to rebuild strength and flexibility.

Recovery from limb lengthening

After the distraction or lengthening phase ends, the bones are allowed to heal and harden, which is the “consolidation” phase. The internal rod remains in place to stabilize the bone while it heals, but there are no further adjustments. Consolidation time varies, but it tends to be about double the lengthening phase. For example, if the bone was lengthened for two months, consolidation may take around four months.

  • You may be advised to avoid weight-bearing activities or intense physical exertion. However, limited walking with the aid of crutches or walkers may be allowed.
  • Physical therapy remains an important part of recovery. You’ll gradually put more weight on the bone and continue to improve muscle strength, joint flexibility, and range of motion.
  • Expect frequent follow-up visits with your surgeon, with scans to track proper bone growth and formation.

In the final stage of rehabilitation, the newly formed bone should be fully hardened and strong enough to support weight and normal movement.

  • You’ll be permitted to walk without crutches or other aids, and you may undergo more intense physical therapy.
  • Depending on the extent of the surgery and the amount of length gained, it may take several more months to feel completely comfortable and back to your full range of motion.
  • In some cases, the internal lengthening rod may remain in the bone permanently. However, the rod may be surgically removed after full healing. This is a less complex procedure than the initial surgery.

Risks and side effects of limb lengthening

Limb lengthening, like any surgical procedure, carries certain risks, such as blood clots. Other side effects of limb lengthening surgery include:

  • Infection: Infection can occur at the incision sites or around the inserted hardware, requiring antibiotics or further surgery to treat.
  • Nerve and blood vessel damage: Injury to nearby nerves or blood vessels can happen during surgery or the lengthening process, leading to numbness, weakness, or circulation issues.
  • Bone healing issues: In some cases, the new bone may not heal properly, leading to delayed healing (nonunion) or improper alignment (malunion).
  • Joint and muscle tightness: As the bone lengthens, nearby joints, muscles, tendons, and ligaments can become stiff or tight, potentially causing discomfort or restricted range of motion. Physical therapy should help prevent these issues.
  • Device complications: The internal lengthening rod may malfunction or shift, requiring corrective surgery.

Innovative approaches to limb lengthening at Penn Medicine

Choosing Penn Medicine means getting exceptional care from surgeons who are recognized globally for their expertise in the latest orthopaedic techniques, including highly advanced procedures for limb lengthening.

Backed by the full resources of Penn Medicine, our team is equipped to offer top-quality care every step of the way. You can expect:

  • Expert surgeons with extensive experience in limb lengthening procedures
  • Access to advanced research and technologies to support precise and safe outcomes
  • Experience treating patients from all over the world, enabling smooth transfer of care and follow-up

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