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Definition: What is a Limb Lengthening Surgery?

While its initial intent was to treat birth deformities and accidents, today limb-lengthening surgeries are being increasingly employed to increase height. In a limb-lengthening procedure or height increase surgery, as it is commonly known, the patient�s tibia and fibula bones are split into two. Next, a nail is inserted in between the halves, directly into the cartilage, and is held in place by an external device known as the Ilizarov Apparatus. The rod gradually pulls the bones apart over three months. Simultaneously, the body�s healing process begins, and new bone, nerves, and arteries grow and fill in the gap.

Procedure: What Happens in a Limb Lengthening Surgery?

The entire height increase treatment, from consultation to recovery, takes about 6-8 months depending on the body�s healing capacities.

Stage 1: Consultation

There are three parts to the consultation:

In the first part, the patient meets with Dr. Sarin and his team to understand the entire procedure for limb-lengthening. The patient�s medical history is also noted in detail.
In the second part, the patient undergoes a thorough physical evaluation, including X-rays and measurements of the limbs. A comprehensive psychological examination is also conducted.
In the third part, the patient is taken to the rehabilitative unit where they will be placed post the height-growth surgery. At the unit, they are introduced to other patients who have undergone the limb lengthening surgery to understand the rehabilitative and recovery process. All questions and queries are personally addressed by Dr. Sarin and his team. Finally, the patient signs a consent form as a formal go-head for the limb-lengthening surgery.

Stage 2: Limb Lengthening Surgery

As explained above, the limb lengthening surgery involves an osteotomy i.e. the tibia and fibula bones in the lower half of the legs are split into two segments. Next, a nail is placed in the intramedullary canal inside the bone and is held in place by the Ilizarov apparatus, placed on the external part of the leg.

The patient spends the next 4 days in the hospital. During the stay, the patient receives epidural injections to reduce the pain in the legs. He/she is closely monitored for any complications from the procedure; any signs are immediately noted and addressed. After four days, the patient is shifted from the hospital to the rehabilitative unit.

Stage 3: Distraction (Limb-Lengthening) Phase

The distraction phase or limb lengthening phase starts from the tenth day of the height increase treatment. Also known as distraction osteogenesis, it involves the growth of new bone at the location of surgery. The external frame around the bone is compensated with pins adjustments, leading to a bone growth of a standard 1 mm per day. The pin is adjusted four times a day in a controlled setting. During the pin adjustment procedure, the body regenerates new tissues in the surgically created gap and the practice continues until the required bone length is achieved. These adjustments are also made to address any deformities that might have resulted from the misalignment of the bone due to trauma. X-rays are taken periodically to monitor the progress of the distraction phase. During this phase, the patients use crutches for movement.

Stage 4: Apparatus Removal

After three months, when the growth in height has been achieved, a second surgery is performed to remove the external apparatus and internally placed the nail. Post the height increase surgery, the recovery and consolidation phase begins.

Stage 5: Recovery & Consolidation Phase

The consolidation phase includes intensive bed rest, physical therapy, and regular X-rays after 6 weeks. This is done in order to ensure that the regenerated bone is strong. The patient will be allowed to walk on crutches during this phase. If their weight exceeds 65 Kgs, they might be advised to use a wheelchair. However, patients are allowed to go home in some cases. Physical Therapy: Starting from the distraction phase, the patients are administered physical therapy on a daily basis. Highly experienced physiotherapists at the rehabilitative facility provide intensive physical training to the patients to reduce stiffness in the muscles.

Outcome: What are the Results of Limb Lengthening Surgery?

The height gain from the surgery varies from 7 to 10 cm, depending on the requirement of the patient and his/her body�s healing capabilities.

Complications: What are the Risks Involved When Undergoing a Limb Lengthening Procedure?

Like any major surgical procedure, leg-lengthening surgeries can also develop complications. Issues can arise due to uncooperative patients as well as a lack of full disclosure from patients about the following factors:

Peripheral vascular diseases

However, most complications and risks can be preempted and avoided by meticulous preoperative preparation and planning, something Dr. Sarin and his medical team are extremely careful and thorough with.