What is Limb Lengthening Surgery?
Limb lengthening surgery is a medical procedure that involves the gradual lengthening of a person’s bone(s) to correct a limb length discrepancy. This discrepancy can occur due to various reasons, such as congenital disabilities, growth plate injuries, bone infections, or trauma.
The surgery involves creating a break in the bone and inserting a device called an external fixator, which is attached to the bone using pins or wires. The external fixator is then adjusted daily or weekly, using a specialized key or wrench, to gradually lengthen the bone. The bone then grows new tissue and fills in the gap created by the lengthening process.
During Limb Lengthening Surgery
Limb lengthening surgery is a complex and lengthy procedure that requires careful preparation and attention to detail. If you are scheduled to undergo limb lengthening surgery, here are some things you should do:
Limb Lengthening Surgery Methods
In general, there are 2 methods used in cosmetic limb lengthening. The choice of method will depend on the individual’s specific needs, the severity of the limb length discrepancy, and the surgeon’s expertise. Each method has its own advantages and disadvantages, and the best method for a particular patient will depend on various factors that need to be carefully evaluated by a medical team.
LON Method
LON stands for Lengthening Over Nails. This method involves the use of an intramedullary nail that is inserted into the bone and used to gradually lengthen the bone over time. The nail has a series of holes that allow for the attachment of an external fixation device to aid in the lengthening process.
Precice Method
The Precice method is similar to LON, but instead of an intramedullary nail, it uses a magnetic telescopic rod that is implanted inside the bone. The rod can be lengthened using an external remote controller, which allows for precise adjustments to be made without the need for daily adjustments.
Advantages of LON Method
There are several advantages to the LON (Lengthening Over Nails) method of limb lengthening:
- Minimally invasive
- Less visible
- Reduced risk of infection
- Improved stability
- Reduced pain
- Shorter lengthening time
It’s important to note that LON may not be suitable for all patients, and the choice of method will depend on individual circumstances and the surgeon’s expertise.
Advantages of Precice Method
The Precice method is a type of limb lengthening surgery that uses an internal lengthening device to gradually increase the length of a limb. Here are some potential advantages of this method:
- Precise control
- Minimally invasive
- Gradual lengthening
- Improved recovery
- Reduced time in external fixators
Disadvantages of LON Method
The LON (Lengthening Over a Nail) method is a technique for limb lengthening that involves the insertion of an internal nail through the bone and then gradually lengthening the nail using an external fixator. While this method can be effective in certain cases, there are also potential disadvantages to consider. Here are a few:
- Risk of complications
- Length of treatment
- Limited weight-bearing during lengthening
- External fixator discomfort
- Joint stiffness
Lengthening Process in the LON Method
In the LON method, the lengthening process is done 4 times a day, and 0.25 mm lengthening is provided in each process. Thus, the patient gains 1 mm in a day, 3 cm in 30 days, 6 cm in 60 days, and 8 cm in 80 days.
The lengthening process starts 3 days after the surgery at the hospital. The healthcare team performs the first lengthening process and teaches the patient how to do this process every day.
Step by Step to LON method limb lengthening procedure Consultation and Travel to Istanbul
- Research and choose a reputable orthopedic clinic or hospital in Istanbul that offers the Precice method for limb lengthening.
- Contact the clinic/hospital to schedule a consultation with a qualified orthopedic surgeon who is experienced in the Precice method. You can provide your medical records and previous imaging to the clinic/hospital before the consultation.
- During the consultation, the surgeon will evaluate your medical history, physical examination, and imaging results to determine if you are a good candidate for the Precice method. They will also discuss the procedure in detail, including risks, benefits, and the recovery process.
- If the surgeon determines that you are a good candidate for the procedure, they will schedule a surgery date and provide you with detailed pre-operative instructions.
- Travel to Istanbul and arrive at the clinic/hospital at least one day before the surgery. During this time, you may be required to undergo pre-operative tests, such as blood work and imaging, and complete any necessary paperwork.
- On the day of surgery, the surgeon will perform the procedure using the Precice method. The surgery typically takes a few hours and is performed under general anesthesia.
- After the surgery, you will be closely monitored by the medical team and may need to stay in the hospital for a few days to manage pain, monitor healing, and receive physical therapy.
- Once you are discharged from the hospital, you will need to attend regular follow-up appointments with the surgeon to monitor your progress and manage any potential complications.
- During the recovery period, you may need to limit weight-bearing activities and follow a specific physical therapy program to optimize healing and restore function.
It’s important to work closely with the medical team throughout the entire process to ensure the best possible outcomes.
Disadvantages of Precice Method
While the Precice method for limb lengthening has many potential advantages, there are also some disadvantages to consider. Here are a few:
- Surgical risks
- Rehabilitation
- Limited applications
- Device-related complications
Lengthening Process in the Precice Method
The lengthening process in the Precice method involves the use of an internal lengthening device that is implanted in the bone. Here are the general steps of the lengthening process:
- Implantation of the device
- Recovery and consolidation phase
- Activation phase
- Consolidation phase
- Removal of the internal device
Step by Step to Precice method limb lengthening procedure Consultation and Travel to Istanbul
- Research and choose a reputable orthopedic clinic or hospital in Istanbul that offers the Precice method for limb lengthening.
- Contact the clinic/hospital to schedule a consultation with a qualified orthopedic surgeon who is experienced in the Precice method. You can provide your medical records and previous imaging to the clinic/hospital before the consultation.
- During the consultation, the surgeon will evaluate your medical history, physical examination, and imaging results to determine if you are a good candidate for the Precice method. They will also discuss the procedure in detail, including risks, benefits, and the recovery process.
- If the surgeon determines that you are a good candidate for the procedure, they will schedule a surgery date and provide you with detailed pre-operative instructions.
- Travel to Istanbul and arrive at the clinic/hospital at least one day before the surgery. During this time, you may be required to undergo pre-operative tests, such as blood work and imaging, and complete any necessary paperwork.
- On the day of surgery, the surgeon will perform the procedure using the Precice method. The surgery typically takes a few hours and is performed under general anesthesia.
- After the surgery, you will be closely monitored by the medical team and may need to stay in the hospital for a few days to manage pain, monitor healing, and receive physical therapy.
- Once you are discharged from the hospital, you will need to attend regular follow-up appointments with the surgeon to monitor your progress and manage any potential complications.
- During the recovery period, you may need to limit weight-bearing activities and follow a specific physical therapy program to optimize healing and restore function.
It’s important to work closely with the medical team throughout the entire process to ensure the best possible outcomes.
Physiotherapy After the Surgery
Physiotherapy after limb lengthening surgery is an important aspect of the overall recovery process. Here are some common techniques and exercises that may be used during physiotherapy:
- Range of motion exercises: These exercises are designed to help improve joint mobility and flexibility. Examples may include gentle stretching, joint mobilization, and passive range of motion exercises.
- Strengthening exercises: As healing progresses, strengthening exercises can help improve muscle function and prevent muscle atrophy. Examples may include resistance training, isometric exercises, and weight-bearing exercises.
- Gait training: Learning to walk with the new leg length can be challenging, and gait training can help improve balance and coordination. This may involve using assistive devices such as crutches or a walker, and gradually increasing weight-bearing activities.
- Pain management: Managing pain during the recovery period is important to ensure that the patient can tolerate physical therapy and daily activities. Pain management techniques may include medication, ice or heat therapy, and transcutaneous electrical nerve stimulation (TENS).
- Education and guidance: The physiotherapist can provide education and guidance on proper positioning, body mechanics, and activity modifications to prevent complications and optimize recovery.
Physiotherapy Before the Surgery (Pre-Surgery)
Physiotherapy before the surgery, also known as prehabilitation, can help prepare the patient for the limb lengthening surgery and optimize outcomes. Here are some common techniques and exercises that may be used during pre-surgery physiotherapy:
- Strengthening exercises
- Range of motion exercises
- Cardiovascular exercises
- Education and guidance
- Pain management