Bone Lengthening Surgery

THE LENGTHENING SURGERY AND HEIGHT LENGTHENING

The limb lengthening surgeries are generally performed in cases of short stature resulted due to congenital and genetic diseases. The procedure will be explained in details in another section because lengthening strategies of those diseases are different. In this section, we will explain the treatments of limb(extremity) shortness developed due to traumas, chronic osteomyelitis, unsuccessful former surgical interventions, chronic resections and fractures of nounion bone loss.

Both limb and height lengthening procedures are performed using the method, which was introduced by a Russian Orthopedician Dr. Ilizarov in 1950s. The method enables 8-10cm lengthening in a single surgery and 35-40cm lengthening with several procedures.

The classical lengthening method using Ilizarov will provide 1mm lengthening by the use of a circular device attached to wires and screws which are passed through the bone. In addition, modern surgical techniques performed by means of lengthening over nail-LON and automated nails are also used today.

WHAT ARE THE PROBLEMS OF THE TREATMENT?

However, Ilizarov is a miraculous method, many problems may also be encountered. First of all, both patients and their family must be ready for a months lasting treatment. In addition, serious problems may develop such as inflammation on soft tissue and in the entrance and exit region of wire and screws on the bone, the failure to generate adequate amount of bone tissue, and skin injuries. Other negative outcomes may develop associated with the use of the other techniques. In classical Ilizarov method, the patients have to carry the fixator with them for 1.5 months to obtain 1cm lengthening. In case of 5cm lengthening, the fixator must be preserved on patients for about 7.5 months, which will be problematic for them. In LON technique, which we apply to shorten the process, the external fixator is removed and the internal nail is preserved when the lengthening is provided. This procedure enables comfort for patients but the performing of the technique is really difficult and requires great surgical experience. Lengthening procedure which, provides only intraosseous lenthening and does not require external fixator by the use of automated nails, is the most advanced modern method. The disadvantages of the method are that the nails are expensive, the lengthening is limited and weight bearing is not possible during lengthening.

DO YOU PERFORM LENTHENING PROCEDURES FOR AESTHETIC CONCERNS?
There are some orthopedicians who perform those surgeries but fairly serious problems may be encountered during the process. Therefore, the success rate can be improved with attentively selection of patients,  by informing the patient and the families about the procedure and providing psychologic support before and during lengthening.