Expert Pediatric Surgeons

LIMB LENGTHENING

When your child has a leg differences and needs limb lengthening, visit your doctor early while your child continues to grow. If you wait, you may miss out on a good time-frame to avoid a larger surgery in the future.

Some conditions are better treated early while growth potential is still possible.

Limb Length Differences

Little girl balancing on side of poolLimb length differences can exist at birth or may develop during childhood. Also, up to 80 percent of human beings may have different leg lengths, and 80 percent of those may not even realize it. When the difference is larger than a couple of inches, it can create problems. On the other hand, the difference may stay the same or may worsen and increase as the child grows.

Our doctors at Medical City Children’s Orthopedics & Spine Specialists can determine the severity of a limb length variance by a simple clinical exam or by X-raying the legs.  In addition, this test is often repeated, sometimes every six months to monitor the limb length difference in growing children.

When and When Not to Treat

The decision to treat limb length differences depends on the amount of variance existing when the child stops growing.  Not all variances need to be treated.  When the difference is warranted, we may recommend using guided growth where we help tether the growth plate to slow down the long leg to allow the short leg to catch up.  If the discrepancy is more than three inches, we discuss lengthening operations on the shorter leg.  Normally, limb lengthening requires a surgical procedure that lengthens bones or replaces segments of missing bone in the upper and lower body. For example, one approach is to insert a rod into the bone that will also gradually lengthen the bone after creating a fracture during surgery. This lengthening is done using external magnetic control.

  Early treatment is recommended with limb lengthening conditions

“When the discrepancy is warranted, we may recommend using guided growth where we help tether the growth plate to slow down the long leg to allow the short leg to catch up. If the discrepancy is more than three inches, we discuss lengthening operations on the shorter leg.” Shyam Kishan, MD

Limb Lengthening Reconstruction Techniques

Limb lengthening and building techniques replace missing bone and lengthen and/ or straighten deformed bone segments. The procedures may be performed on children with limb-length discrepancies due to birth defects, diseases, or injuries. The limb lengthening correction process work on the principle of distraction osteogenesis. This new concept reverses the long-held belief that bone cannot regenerate.

In this process, a bone cut during surgery can be gradually distracted (pulled apart), leading to new bone formation (osteogenesis) at the site of the lengthening. In this way, bone segments can expand to 100 percent of their original length. We use a variety of techniques, including the use of monolateral (one-sided) and circular external fixation devices, to correct angular deformities as well as limb length discrepancies. The regenerated bone appears normal and does not wear out. The muscles, nerves, and blood vessels grow in response to the slow stretching like they do during a growth spurt.

Limb Lengthening Procedure

The actual procedure, classified as minimally invasive, requires only one or two nights in the hospital. Patients do not experience pain since limb lengthening is so gradual and patients can continue to walk during the treatment. Children with congenital deformities will often possess unequal leg length caused by the illness. Many adults acquired this condition during childhood and since developed back pain and hip arthritis from the leg length discrepancy. Growth plate fractures and bone infections in children can cause stunting of growth that results in leg variances.  Following trauma, bones can heal in a shortened and deformed position (malunion).

Sometimes the bone can even remain unhealed (non-union). Limb lengthening procedures address all these issues. We can successfully correct large deformities and equalize limbs with discrepancies of several inches. A segment of bone can be missing after a bone tumor, bone infection, or severe fracture. We can transport new bone to fill in this defect.

Our physicians at Medical City Children’s Orthopedic and Spine Specialists possess experience and expertise in the treatment of limb lengthening. Finally, our board-certified doctors provide opportunities for patients who previously believed that they had no help for this problem.

Call 214-556-0590 to make an appointment.

Medical services for children from birth through adolescence at four convenient
locations: Arlington, Dallas, Frisco, and McKinney.