The Complete Five-Year Case: Leg, Clavicle, and Humerus Lengthening in One Patient
- Dr. Yuksel Yurttas Team
- Feb 16
- 6 min read
Updated: 4 hours ago
Over the course of five years, one patient underwent three separate leg lengthening procedures, followed by bilateral clavicle lengthening and, most recently, bilateral humerus lengthening with the Fitbone system.
This was not a five-surgery plan established at the beginning.
The patient was young, physically active, and worked as a fitness trainer. He entered his first treatment in strong physical condition and remained highly committed to rehabilitation throughout the years that followed. Just as importantly, each later procedure was considered only after the previous one had healed and his recovery, function, imaging, and overall condition could be evaluated.
His treatment is now complete. The cumulative changes were:
20 cm of total height gain
5.4 cm of additional shoulder width
12 cm of additional arm span
The numbers are unusual, but they make more sense when the case is viewed as what it actually was: a series of separate decisions made over several years, with recovery between each stage.
The First Stage: 20 cm of Height Through Three Leg Lengthening Procedures
The patient's treatment began with bilateral tibial lengthening using the LON method.
At that point, there was no predetermined plan for him to later undergo femur lengthening, a second tibial procedure, clavicle surgery, or arm lengthening.
The first goal was simply to complete the initial tibial lengthening and recover from it.
First Tibial Lengthening: +7 cm
During the first procedure, both tibias were lengthened by approximately 7 cm.
The patient was already accustomed to structured physical training through his work in fitness, and that discipline carried into his rehabilitation. Over the following months, attention was placed on bone healing, joint mobility, muscle flexibility, walking mechanics, and restoration of normal function.
He completed the recovery period successfully.
Only later, after returning to normal activity and after the result of the first treatment had been reviewed, did the possibility of another lengthening procedure become a serious discussion.
Femur Lengthening With PRECICE 2: +8 cm
The second procedure involved bilateral femoral lengthening using the PRECICE 2 system.
The femurs were lengthened by approximately 8 cm.
This brought his cumulative height increase to approximately 15 cm.
The decision to proceed was not based simply on the fact that the patient wanted additional height. His recovery from the first operation, physical condition, joint function, previous bone healing, and ability to comply with another prolonged rehabilitation period were all relevant before another major procedure was considered.
The femoral lengthening and subsequent recovery were completed without major problems, and the patient eventually returned to an active lifestyle.
For most patients, treatment would have ended there.
In this case, after another period of recovery and follow-up, the patient later asked whether additional tibial lengthening could be considered.
Second Tibial Lengthening: +5 cm
The third leg procedure again involved both tibias and was performed using the LON method.
A previous tibial lengthening makes the decision to operate on the same bone again substantially different from considering a first-time procedure.
In general, tibial lengthening is more conservatively limited due to its anatomical constraints and soft-tissue tolerance, and exceeding 5 cm is typically approached with caution.
In this case, however, the patient’s prior excellent bone regeneration, stable alignment, and full functional recovery after the first tibial lengthening allowed for a carefully staged extension beyond standard limits.
The second tibial procedure was therefore not treated as an automatic continuation of his previous surgeries.
After evaluation and planning, approximately 5 additional centimeters of tibial lengthening were completed.
Across the three separate leg procedures, his cumulative height increase reached approximately 20 cm.
By the end of this period, he had gone through years of surgery, distraction, consolidation, and rehabilitation while maintaining the level of commitment required to repeatedly return to physical activity.
He later returned to fitness training and was able to exercise at a high level again.
How His Proportions Changed After 20 cm of Height Gain
A 20 cm increase in standing height is a major change to the dimensions of the body.
His legs had become substantially longer, but his shoulder width and arm span remained essentially those of his original frame. As he returned to training and became accustomed to his new height, he became increasingly aware of that difference in proportion.
This did not mean that another operation was medically necessary.
Most patients who undergo leg lengthening will never require or pursue clavicle or arm lengthening. These are separate procedures with their own indications, limitations, and considerations.
In this patient's case, however, the concern remained after his leg treatment had been completed.
The next discussion was therefore not about gaining more height. It was about whether anything should be done at all about the proportions of the upper body.
Eventually, bilateral clavicle lengthening was considered.
Bilateral Clavicle Lengthening: +5.4 cm of Shoulder Width
The fourth procedure involved both clavicles.
During clavicle lengthening surgery, an osteotomy was performed on each clavicle, followed by gradual distraction.
The final lengthening was:
Right clavicle: +2.7 cm
Left clavicle: +2.7 cm
This produced approximately 5.4 cm of additional skeletal width across the shoulders.
The procedure changes the underlying bony width of the shoulder girdle rather than relying on muscle development or posture to create the appearance of broader shoulders.
Again, the operation was approached as a separate treatment rather than the next item in a predetermined sequence.
By this point, Prof. Dr. Yüksel Yurttaş had already followed the patient through three previous lengthening procedures and several years of recovery. His previous healing pattern, functional recovery, physical condition, and ability to follow postoperative instructions were therefore known in considerably more detail than they would be in a first-time patient.
The clavicle lengthening was completed, followed by another recovery period.
Only after that stage was behind him did the possibility of changing his arm span become the final part of the discussion.
Bilateral Humerus Lengthening With Fitbone
The fifth and final procedure was bilateral humerus lengthening.
For this stage, Prof. Dr. Yüksel Yurttaş used the Fitbone intramedullary lengthening system in both humeri.
Unlike an external fixation system, the lengthening mechanism is implanted inside the bone. After surgery, gradual distraction increases the distance between the bone segments while regenerate bone develops within the gap.
Arm lengthening brought a different set of considerations from the previous procedures.
The humerus has different anatomy, surrounding nerves, soft-tissue behavior, and functional demands from the femur or tibia. The fact that the patient had successfully completed several previous lengthenings did not by itself establish that humerus lengthening would be appropriate.
His upper-extremity anatomy, previous clavicle procedure, physical condition, range of motion, treatment history, and capacity for another lengthy recovery period had to be considered independently.
After evaluation and planning, both humeri were treated during the same surgical stage.
The final result was 6 cm of humerus lengthening on each side.
This added approximately 12 cm to his total arm span.
The distraction phase was completed successfully, followed by consolidation and rehabilitation as the newly formed bone matured.
With the completion of this stage, the patient's multi-year sequence of lengthening procedures came to an end.
The Final Result
Across all five procedures, the cumulative changes were:
Legs
Three separate bilateral leg lengthening procedures:
Tibia: +7 cm
Femur: +8 cm
Tibia: +5 cm
Total height increase: approximately 20 cm
Shoulders
Bilateral clavicle lengthening:
Right side: +2.7 cm
Left side: +2.7 cm
Total additional shoulder width: approximately 5.4 cm
Arms
Bilateral humerus lengthening:
Right arm: +6 cm
Left arm: +6 cm
Total additional arm span: approximately 12 cm
Taken together, this is an unusual treatment history involving lengthening of four different anatomical regions: the tibias, femurs, clavicles, and humeri.
Five Procedures, but Not One Treatment Plan
Looking at the completed case today, it is easy to compress five years into a list of procedures and measurements.
That would give the wrong impression.
The patient was not approved for five surgeries at the beginning of treatment, and there was never an automatic assumption that completing one operation meant another should follow.
There were long intervals between stages.
There was healing to observe, function to recover, imaging to review, rehabilitation to complete, and new decisions to make.
The patient's age, strong physical condition, fitness background, rehabilitation discipline, and history of good recovery were favorable factors throughout this process. But even in the same patient, previous success did not remove the need to reconsider the next procedure on its own merits.
That distinction became increasingly important as his surgical history grew.
By the time humerus lengthening was discussed, Prof. Dr. Yüksel Yurttaş had followed the patient through years of treatment and had first-hand knowledge of how his bones, joints, soft tissues, and overall function had responded to previous procedures.
That continuity allowed later decisions to be made with an unusually detailed understanding of the individual patient.
This Is Not a Standard Limb Lengthening Treatment Sequence
This case should not be interpreted as a model that other patients are expected to follow.
Most patients undergoing leg lengthening surgery do not undergo three separate lengthening procedures. Far fewer later consider clavicle or humerus lengthening.
The amounts achieved in this patient should not be treated as targets for another person either.
Bone dimensions, alignment, joint condition, soft-tissue flexibility, nerve tolerance, previous surgery, healing response, rehabilitation performance, physical condition, and individual anatomy all affect what can reasonably be considered.
Two patients asking for the same number of centimeters may receive very different recommendations.
In this case, the eventual result was possible only through a treatment history that unfolded gradually and was repeatedly reassessed over several years.
Considering Limb Lengthening or Arm Lengthening?
Patients considering limb lengthening, humerus lengthening, or another lengthening procedure can contact us on WhatsApp at +905339735289 for an individual evaluation.
Previous surgeries, current X-rays, anatomy, physical condition, treatment goals, and medical history all need to be reviewed before discussing what may be appropriate for a particular patient.
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