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  • Dr. Yuksel Yurttas

Risks, Complications, and Side Effects of Limb Lengthening Surgery: A Comprehensive Guide

Are you thinking about taking the leap and undergoing limb lengthening surgery to increase your height? Before you proceed, it's important to be informed about the potential risks, complications, and side effects associated with the procedure.


In this informative article, we will take an in-depth look at the possible risks, complications, and side effects of limb lengthening surgery, providing you with the knowledge necessary to make an informed decision. From slow or rapid bone healing to muscle contractures and osteomyelitis, we will cover it all. By gaining a comprehensive understanding of the procedure and recovery process, you can confidently weigh the benefits and risks and make the best decision for yourself. Don't let the fear of the unknown hold you back from achieving your desired height, read this essential guide before making your decision.


The Surgery Process


The limb lengthening surgery process begins with an operation known as an osteotomy, in which the orthopedic surgeon cuts the bone to be lengthened. The surgeon then uses an external fixator or internal nail to fix the bones in place. After the surgery, the bone is gradually lengthened over time, allowing the body to form new bone tissue to fill the gap. The treatment process is lengthy and requires close monitoring and follow-up care.


Risk and Complications


The possible risks, complications, and side effects of limb lengthening surgery include:

  1. Slow or rapid bone healing

  2. Muscle and joint complications

  3. Osteomyelitis (bone infection)

  4. Nerve and blood vessel injury

  5. Pin loosening (LON and external methods)

  6. Pin site infection (LON and external methods)

  7. Postoperative swelling

  8. Pain and sleeping difficulties

  9. Psychological impact

Let's examine the risks and complications of limb lengthening surgery in more detail.


1. Slow or Rapid Bone Healing


Limb lengthening procedures involve the formation and healing of new bone. In some cases, the bone may heal too quickly or too slowly. The healthcare team regularly takes X-rays of patients and monitors their progress to detect such conditions.


a. Rapid bone healing


Some people may experience faster bone healing which is a biological reaction specific to that person and not caused by any negligence or misapplication of the procedure. If rapid bone healing is observed during the lengthening phase, the doctor may increase the daily lengthening amount to stabilize the process. However, if the bone union has already occurred due to rapid bone healing, an additional surgical procedure may be required for correction.


b. Slow bone healing


In some patients, new bone may not form as quickly as it should. This is one of the complications that can be detected by X-ray during the lengthening phase and can be overcome by intervention. In such cases, the doctor may decide to reduce the daily lengthening amount, resulting in treatment taking longer than expected.


c. Nonunion


In rare cases, the bone union may not occur, a condition known as nonunion. In such cases, the doctor may decide to stop the lengthening procedure, reverse it, or perform an additional surgical procedure to correct the issue.


2. Muscle and Joint Complications


During limb lengthening procedures, it is important for muscle adaptation to keep pace with the bone extension. A mismatch of bone and muscle length can negatively affect the mobility of the leg and result in postoperative complications such as muscle contractures and joint stiffness.


a. Muscle contractures


These occur when the muscles do not adapt to the bone extension, causing pain and difficulty in movement. To prevent muscle contractures, patients should follow a regular exercise program and receive physiotherapy sessions.


b. Joint stiffness and contractures


These occur when muscles become too tight, pulling on the surrounding joints and causing difficulty in joint mobility. To prevent and treat joint stiffness and contractures, patients should follow a regular exercise program and receive physiotherapy sessions. In rare cases, surgical intervention may be necessary to correct joint stiffness or contractures. It is important to note that early physical therapy intervention can help in preventing muscle and joint contractures.


3. Osteomyelitis (bone infection)


Osteomyelitis, also known as bone infection, is a potential complication that can occur following limb lengthening surgery, particularly in methods that involve external fixation. To prevent osteomyelitis, patients should maintain proper hygiene, follow post-operative care instructions and avoid exposing the surgical site to dirt or bacteria.


Additionally, regular needle site dressings and bandage changes can also help minimize the risk of infection. If osteomyelitis is detected, it can be treated with antibiotics and pain relievers in the early stages, but surgical intervention may be necessary in some cases.


4. Nerve and Blood Vessel Injury


During limb lengthening procedures that involve external fixation, there is a small risk of injury to nerves and blood vessels. This can occur due to the insertion of pins and wires into the bone, which may compress or damage surrounding nerves and blood vessels.


a. Nerve injuries


Nerve injuries can result in temporary or permanent loss of sensation or movement. Treatment for nerve injuries may include physical therapy, nerve stimulation, and in some cases, surgical intervention.


b. Blood vessel injuries


Blood vessel injuries can cause blood loss and may require surgical repair in severe cases. These injuries are rare but it is important to be aware of the potential risks and to seek medical attention immediately if any symptoms occur.


5. Pin loosening (Methods with External Fixation)


In limb lengthening methods that require external fixation, such as the LON method, pin loosening is a possible complication that can occur due to various technical factors. These factors may include improper insertion technique, frame stiffness, and poor anchorage. Pin loosening can compromise the stability of the fixation and may require additional surgical intervention to correct. It is important to note that pin loosening is not a common complication and can be minimized by following proper post-operative care instructions and closely monitoring the fixation during the healing process.

LON method limb lengthening pin sites
Regular pin sites dressing minimizes the risk of possible complications in limb lengthening procedures that requires external fixation.

6. Pin Site Infection (Methods with External Fixation)


Pin site infections can happen during limb lengthening procedures that use external fixation like the LON method. These infections can be caused by bacteria at the surgical site, poor dressing changes, or other issues. They can cause pain, slow healing, and other problems. To prevent pin site infections, it's important to keep the surgical site clean, follow post-operative care instructions, and monitor the surgical site closely. Treatment might include antibiotics, wound care, and surgery in some cases. On the other hand, the Precice 2 method does not have this risk because it is fully internal and does not use external fixation.


7. Postoperative swelling


Postoperative swelling is a normal response to surgery and is caused by the accumulation of fluid in the affected area. It is a common complication after limb lengthening surgery and can cause discomfort, pain, and difficulty in movement. The swelling can also impede the healing process and delay recovery time. To manage postoperative swelling, patients are typically prescribed medication, such as non-steroidal anti-inflammatory drugs (NSAIDs) and compression garments, and undergo physical therapy to help reduce inflammation and improve circulation. Physical therapy exercises can also help to improve the range of motion and prevent stiffness in the affected limb. In some cases, the surgeon may also use a technique called intermittent pneumatic compression to help reduce swelling and promote healing. Additionally, elevation of the affected limb, and keeping the limb active can also help in reducing the swelling


8. Pain and Sleeping Difficulties


Pain is a common experience for patients undergoing limb lengthening procedures and can range from mild discomfort to severe pain. Pain is typically highest in the days immediately following surgery and gradually decreases over time with proper management and pain control. However, pain tolerance and sensitivity can vary greatly among patients, and some may experience difficulty sleeping due to pain.


The healthcare team and surgeon will work closely with patients to manage pain and ensure that treatment protocols are tailored to each individual's needs. This may include a combination of medication, physiotherapy, and other pain management techniques. It is important for patients to report any pain or sleeping difficulties they are experiencing to their healthcare team so that appropriate action can be taken to alleviate symptoms.


9. Psychological impact


Undergoing limb lengthening surgery can be a significant emotional and physical journey. It's important to have realistic expectations and to be prepared for the process, including the treatment period and recovery time. While the procedure can have life-changing benefits, it's important to keep in mind that there may also be potential emotional challenges to consider.



What should be done to avoid potential risks, side effects, and complications of limb lengthening surgery?


To avoid possible risks, side effects, and complications associated with limb lengthening and deformity correction procedures, it is important to take the following precautions:


a. Choosing a qualified and experienced surgeon


To ensure the best possible outcome and minimize the risk of complications, it is crucial to choose a highly qualified and experienced surgeon who specializes in limb lengthening and deformity correction procedures. Research different surgeons, read patient reviews, and consult with other healthcare professionals before making a final decision. Additionally, patients should prefer advanced methods, discuss options, and consider the method choice as different methods may have different levels of risks and complications before making a final decision.


b. Learn about the lengthening and treatment process


Before and after surgery, the surgeon and healthcare team should provide you with detailed information about the procedure and its potential risks. Make sure to understand and follow the doctor's instructions carefully.


c. Follow the doctor's instructions during treatment


It is important to follow the doctor's instructions during the treatment process, including taking x-rays at regular intervals and sharing any changes in your health condition with the healthcare team and surgeon.


d. Be aware of possible complications


Be aware of other complications and make sure you get the right care. Your surgeon will tell you about the most common risks and side effects, but there may be other potential complications as well. Get all the information you need and make sure you get the care you need.


e. Communicate with your healthcare team


Keep an open line of communication with your surgeon and healthcare team throughout the treatment process. This will help ensure that any issues or concerns are addressed quickly and effectively.


After exploring the risks, complications, and side effects of limb lengthening surgery, it is important to understand that the key to a successful outcome is choosing the right professional. We, Prof.Dr.Yuksel Yurttas and his professional team, are committed to providing our patients with the highest level of care and treatment. Our team is composed of highly qualified and experienced surgeons, nurses, and healthcare professionals who specialize in limb lengthening and deformity correction procedures. To understand the long-term effects of limb lengthening surgery, we recommend you to read more about it as well.


For further information and a free personalized consultation, please contact us via WhatsApp at +90 533 973 5289 or info@dryukselyurttas.com. We are dedicated to helping you achieve your desired outcome and make the most informed decision for your treatment. With our expertise and state-of-the-art facilities, we are confident in our ability to provide you with the best possible care and outcome.

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