• Dr. Yuksel Yurttas

All You Need to Know About Limb Lengthening Surgery

In this article, we compiled all you need to know about limb lengthening surgery; how and where to start the procedure, what phases you will go through, the difficulties you will encounter at these phases, the process of returning to daily life, and the result that you'll get at the end of the procedure.

The only permanent solution to short stature in adults is limb lengthening surgery. After puberty, the growth plates close and the body doesn't naturally produce new bone. Thanks to technological developments in the field of orthopedics, adults can now reach their dream height in less than a year.

In recent years, interest in limb lengthening surgery has been increasing. However, with this interest, unsuccessful cases are also increasing. One of the main reasons for this is the number of inexperienced orthopedic surgeons performing limb lengthening surgery and the unrelated people attempting to market the surgery and post-operative services on behalf of surgeons to make money.

We recommend that you pay attention to the details we share so that you don't become a victim of profit-oriented organizations.

1- Consultation

Before having this surgery, patients go through a lengthy research process. At this phase, it is essential to communicate directly with the surgeons and your research. The first step you should take is to choose the right surgeon and lengthening method for you and get a one-on-one consultation from the surgeon before the procedure.

Many good surgeons provide free consultation and avoid incurring additional costs to their patients. At the consultation, meet your surgeon, explain your medical history, and ask if you are suitable for surgery. Make sure you have the answers to all the questions you have in mind.

Watch out here! The language of medicine in the world is English. Therefore, if you go abroad for limb lengthening surgery, you should prefer a surgeon who can speak English and communicate directly with you. There are two reasons for this. The first is that your surgeon can follow and apply medical developments worldwide. The second is that the slightest misunderstanding can lead to irreversible consequences.

You'll be registered at the hospital once you've decided on a surgery date. Then you proceed to the preoperative phase, which is the second phase.

2- Pre-surgery

You've opened the door to a taller life. You are now closer to your dream height. This phase includes the processes from travel planning to accommodation arrangements, from your first examination to pre-operative tests, and ends on the day of surgery.

Before limb lengthening surgery, you must pass a series of medical tests and examinations. The most important tests are the orthoroentgenogram (an x-ray that determines the exact length of your leg), blood test, and bone density test if necessary.

The orthoroentgenogram is a radiographic test used to determine anatomical leg length and to calculate leg-length discrepancies.

In this phase, the healthcare team and the surgeon will provide you with the most detailed information about the procedure and prepare you for the surgery.

3- Surgery and Hospitalization

The 3rd phase starts from your hospitalization and covers the time from the surgery until the day you are discharged.

From the day you are admitted to the hospital, you will be under the close supervision of the healthcare team and the surgeon. Trained caregivers who speak your language perfectly are with you throughout the whole process and will meet all your needs.

Limb lengthening surgery is performed with your preferred method (LON method, Precice 2, Precice Stryde) and takes approximately 1.5-2 hours. Although the procedure is usually performed with local anesthesia, it can also be performed with general anesthesia according to your preference. The day after the operation, you will not feel pain due to the effect of anesthesia and the drugs to be given.

The day after the surgery is the day when the pain is most severe. That day you are given strong painkillers and you sleep through the day. The doctor visits periodically and checks your condition. You are also under the constant supervision of the healthcare team.

You will feel better 2 days after the operation. Your pain will continue, but the pain is kept under control with painkillers.

limb lengthening hospitalization
The first lengthening procedure and the first physiotherapy session are done during hospitalization.

The healthcare team will perform your first lengthening and show you how to do it on the 5th day following surgery. They will provide instructions on how to make daily distractions (lengthening), clean pin sites, and change bandages (only for the LON and external methods). The healthcare team will double-check that you can follow procedures on your own.

During your hospital stay, a specialist physiotherapist will also visit you, do physical therapy sessions, and assist you in taking your first steps.

When everything returns to normal and you feel better, you will be discharged from the hospital on the fifth or sixth day.

4- Post-surgery

This phase is the longest and most curious part of limb lengthening surgery.

Following you are discharged from the hospital, whether you continue your lengthening phase at home or get physiotherapy and postoperative care under the supervision of a healthcare team, you will go through the same process and face the same challenges. However, we recommend that you be under the supervision of our expert healthcare team and physiotherapist during this process. Thus, you can be protected from possible risks, complications, and side effects at the maximum level.

Let's take a deeper look at the procedure you'll go through in this phase.

Distraction phase (Lengthening)

You use screws from external fixators (LON) or the remote control device (Precice) to lengthen your legs by about 1mm each day. It is natural to have pain in this process. Pain is relieved with painkillers prescribed by your doctor.

precice 2 lengthening process
Precice 2 - Daily Lengthening Process

By the 2nd week after surgery, most patients can walk with crutches, walkers, or without any assistance.

In about 1 month or more, when you reach 3-4 cm, pain and tension will occur in the leg muscles. For this reason, you should take 1-3 physical therapy sessions per week.

If you want to continue the lengthening phase at home, you can do the exercises suggested and taught at home. However, this is often not enough. The harder you push yourself to exercise and walk, the faster your bone regeneration process and recovery will be.

You will reach 3 cm in about 1 month. When you reach this level, pain and tension will occur in the leg muscles. For this reason, you should take 1-3 physical therapy sessions per week.

X-rays of your legs should be taken at least once a month to monitor your growth and bone regeneration progress.

Patients who want to continue their treatment at home communicate with the doctor over the internet and send their x-rays for control. During this process, you can stay in constant contact with the healthcare team and doctor, and get 24/7 support.

In external and LON methods, the doctor will invite you for device removal after evaluating your x-rays. This usually takes around 2-6 weeks after the end of the lengthening phase.

In the Precice 2 method, you can start walking without any assistance after the adequate bone union is achieved ( about 4-8 weeks after the end of the lengthening phase)

The distraction phase ends after the patient achieves the desired amount of growth and adequate bone generation.

Consolidation Phase

The bone consolidation phase takes approximately 3-5 months after completion of the distraction (lengthening) phase. In this process, you should pay attention to a diet rich in protein and calcium. You should also exercise and walk without being heavy.

Precice 2 X-ray
Precice 2 - Patient X-ray

During the bone consolidation phase, you will be able to walk normally as usual (4-5 months after the surgery), go to work, and do your all daily activities.

After the bones are fully consolidated, the internal nails placed in the bone marrow can be removed with a minor operation.

Internal nail removal surgery takes about 1 hour. You will be discharged the day after the surgery and you can continue all your daily activities within a few weeks.

Full Recovery

Your bones are now completely healed and you are fully recovered. Your new bones are as strong as -even stronger than- your existing bones. You can do all sports, including running and weight lifting, and perform the heaviest physical activities.

If you want to grow more, you can have the second leg lengthening surgery from the other leg area with peace of mind.

The happiness of our patients is our greatest motivation. For this reason, we'll keep in touch with you throughout the process and after you've fully recovered, and we'll check on your health at regular intervals.

Have questions or need further information? Contact us now for a free personalized consultation directly from the doctor's office. (WhatsApp +90 533 973 5289, E-mail: info@dryukselyurttas.com - Wechat ID: dryukselyurttas)

You can also join our subreddit from the link below and ask all your questions about limb lengthening surgery on Reddit.