Lengthening of bone

Leg lengthening and shortening of bone are two modalities for treatment of limb length difference.

The different modalities that can be used are
• Lengthening of an abnormally short bone
• Shortening of an abnormally long bone
• Limiting growth of the long bone using temporary epiphysiodesis so that the short bone can catch up with the long bone

Lengthening of bone

With the advent of newer surgical techniques it is now possible to lengthen a bone using Ilizarov or monolateral fixators. The bone that is usually short is lengthened. On an average the bone can be lengthened 6-8 cm in one sitting. The bone is cut and lengthened at a rate of 1mm per day. Using gradual lengthening the muscles, nerves and vessels also lengthen. The results of this method are time tested and proven. However complications like pin tract infection, contracture of tendoachillis and problems of bone regenerate are possible and hence regular followup is required.

Shortening of abnormally long bone

Small segment of the bone is removed and stabilized with a plate or rod. This method is usually not preferred by the patient as operation is done on the normal leg and the child will also become short.

Limiting growth of the long bone

In children growth of the longer limb can be stopped temporarily using ‘8’ plates. The timing of the surgery is important and growth charts and tables are available which can help the surgeon. There are very few and minor complications of this procedure and hence is preferred by many patients.

Long leg radiograph showing 10 cm shortening of right lower limb
Clinical photo of Ilizarov ring fixator in site
Radiograph showing bone regenerate at lengthening site
Clinical photo after lengthening