Limb Lengthening Surgery: A Comprehensive Guide to Height Increase Procedures

Limb Lengthening Surgery

Rapidly advancing technology continues to present new methods in the medical field. These methods, in the hands of skilled physicians, continue to serve as a beacon of hope by finding solutions to all ailments of individuals.

Medical science, which finds solutions for people's illnesses in many areas, also solves problems for individuals who have lost their self-confidence due to aesthetic concerns, thereby restoring their lost confidence.

Limb lengthening is another procedure preferred by both men and women and performed due to aesthetic concerns. In this article we have prepared for you, we will discuss how patients who do not want short stature due to certain reasons can increase their height and what awaits them.

What is Limb Lengthening Surgery?

Height growth stops in individuals after a certain age due to the closure of growth plates. In such cases, individuals whose height remains short and does not continue to grow become dissatisfied with this situation and seek solutions in limb lengthening surgeries.

The limb lengthening process takes a relatively long time. Through surgical operation, the bone to be lengthened is cut and opened gradually at a rate of 1 millimeter per day, allowing the gap to fill with bone. This procedure is called distraction osteogenesis. In other words, bone naturally grows in the opened gap and height begins to increase.

If a person's height extension is up to 8 centimeters, surgical operation is performed either on the femur (the upper bone) or the tibia (the lower bone). If the extension will be 10 centimeters or more, the bone lengthening procedure is performed on both bones.

Along with these procedures, the nerves, blood vessels, muscles, and all other tissues surrounding the person's bone structure adapt and expand without experiencing sudden opening, since the process progresses slowly.

Who is Limb Lengthening Surgery Applied to?

Limb lengthening surgery is applied to individuals experiencing short stature for various reasons. Growth plates remain open in people until the age of 18-20 years and height continues to increase; after these ages, height growth stops due to the closure of growth plates.

Waiting until the age of 20 for a person to undergo height extension surgery would be quite a healthy decision. Due to certain reasons, in patients diagnosed with dwarfism at an early age, limb lengthening surgery is performed at the age of 3. This operation, performed in 2-3 stages, is performed in a single session in 10-year-old children, depending on the patient and height condition. The upper age limit for limb lengthening procedures is 45-50 years.

How Many Centimeters Does Limb Lengthening Surgery Extend Height?

Every surgery is individual. For this reason, it would not be accurate to state a specific number. The amount the person wishes to extend and the amount recommended by the doctor for the patient affects this number. The doctor and patient should consult beforehand before deciding on the process, and the most appropriate method should be selected for the patient.

To answer the question about limb lengthening surgery that everyone wonders about—how many centimeters it extends—an increase of 7-10 centimeters can be achieved over a 4-6 month period. In some cases, by applying appropriate methods and techniques to both the femur and tibia bones, the extension can reach up to 15 centimeters.

What are the Limb Lengthening Surgery Methods?

In limb lengthening surgery, there are multiple methods and techniques applied by physicians. We can list these for you as follows:

• Ilizarov Circular Fixator Method for Limb Lengthening Technique
• Combined Method for Limb Lengthening (LON: Lengthening Over Nails)
• Precice Intramedullary Method for Limb Lengthening Technique
• Precice Stryde Method for Limb Lengthening Technique
• Holyfix Method for Limb Lengthening Technique

Most Commonly Used Method: LON (Lengthening Over Nails)

The most frequently used limb lengthening technique is the LON (Lengthening Over Nails) method, in which an internal nail (intramedullary nail) and an external fixator are used together. This method is generally applied to the long bones of the leg—the femur (thighbone) and tibia (shinbone); in appropriate cases, it may also be used in other areas such as arm bones.

During the procedure, the surgeon makes two incisions above and below the bone to be lengthened, and places a nail inside the bone. This nail has holes where the external fixator can be attached. The external fixator is attached to the nail through rods, and these rods are adjusted at regular intervals to gradually lengthen the bone. Once the target length is reached, the external fixator is removed; the nail may remain inside the bone for a while longer.

Some prominent features of the LON method are as follows:

• Offers a relatively simple and understandable application process.
• Is considered less invasive compared to some other techniques.
• Can facilitate daily life since the duration of the external fixator remaining in the body can be shortened.

As disadvantages, the bulk of the external fixator and potential discomfort for a period, the possible need for two separate surgical procedures to insert and later remove the nail, and the necessity of being careful against damage or impact to the fixator can be cited.

Holyfix Method

The Holyfix technique is a surgical method applied by creating controlled bone cuts in the limbs. After surgery, a personalized rehabilitation process begins for the patient; in this process, an external fixator supported by physiotherapy and special exercises applies gentle tension to the cut bones, promoting new bone tissue formation and gradual bone lengthening. Like other limb lengthening methods, this technique may carry certain risks; therefore, it is important to be evaluated in detail by an experienced physician before beginning the process.

How is Limb Lengthening Surgery Performed?

As with all surgeries, limb lengthening surgery is performed under either general or local anesthesia. In this two-stage surgical procedure, the bone of the leg to be lengthened is first cut transversely into two pieces. Following this cutting procedure, called osteotomy, the leg is stabilized with certain leg fixation devices.

The new bone tissue that will form in the gap created by the bone separation is called distraction osteogenesis. To allow new bone tissue to form in the space between the separated bones, the placed device is opened four times daily. The size of this opening is one quarter of a millimeter. By the end of the day, the device will have been opened by 1 millimeter.

During the treatment process, it is important that the person does not bear weight on the foot and walks with crutches.

In the second stage of the treatment process, the formed bone heals and fully hardens. At this stage, the person is no longer dependent on crutches and can begin walking normally. Following necessary examinations and clinical evaluation, if healing is confirmed by X-ray imaging of the treated leg, the placed device is now removed. The new bone formed in the person's body is as strong and healthy as other bones.

The duration of hospital observation following surgery is two days. Unless extra complications develop, this period may not be extended. Although there are no large deep scars on the person's body, the scars from this surgery are quite small.

How Long Does Limb Lengthening Surgery Take?

Every illness is different, and each treatment process varies by individual. If no unforeseen complications develop during surgery, this procedure typically takes an average of 1.5 to 2 hours. Following treatment, the patient remains under observation for two days and is discharged from the hospital at the end of two days.

The complete treatment process varies depending on the treatment method and techniques used by the doctor, the patient's age, and the centimeters to be lengthened.

For example, in limb lengthening methods performed with devices placed inside the bone; extending height by 5 centimeters for an adult requires a 4 to 6 month treatment period.

When Can Normal Movement Resume After Limb Lengthening Surgery?

In the first weeks following surgery, the stabilization device attached to the outside of the leg maintains bone alignment and aids in healing; during this period, since the device is bulky and somewhat restrictive, movement is limited.

Once the bones enter the healing process, the physician removes the external fixator; this typically occurs approximately 3-4 months after surgery. After the device is removed, freer movement of the leg becomes possible; however, time is still needed for the bones to fully heal and for movement range to be regained. During this period, following the physician's instructions and regularly participating in a physiotherapy program supports the healing process.

After fixator removal, many patients can begin walking without crutches within a certain timeframe; since this timeframe varies from person to person, it is important to carefully monitor the body's signals and progress without forcing the process.

Some points to consider in gradually regaining movement capability:

• Begin with short distances and gradually extend distance as muscle strength increases.
• When pain is felt, stop and rest; do not attempt to progress by resisting pain.
• Continue physiotherapy exercises regularly; these exercises help regain movement range and muscle strength.
• Be patient; full bone healing and return of movement capability to normal takes time.

What Are the Risks of Limb Lengthening Surgery?

Every surgical procedure carries risks according to its level. However, since limb lengthening procedures generally result in success at a rate of 95%, very few complications and risks are observed. However, it is very important to consult with a good physician.

The doctor and patient should conduct a pre-operative examination, inquire about medications used by the patient, any adverse reactions to anesthesia, and past medical histories, and an operation plan should be made accordingly.

If you do not choose your surgeon well and have this surgery performed by non-specialist and less skilled individuals, walking disturbances may occur, angular problems may develop, and deep scarring may result.

Other possible risks and complications that may be associated with limb lengthening surgery include:

• Infection
• Nerve damage
• Blood clot formation
• Bone fracture
• Improper bone healing (malunion)
• Leg length discrepancy

Most of these risks are minimized through proper planning by an experienced surgical team, regular follow-up, and patient compliance with the treatment process.

Possible Advantages of Limb Lengthening Surgery

• Height increase: The primary goal of limb lengthening surgery is to increase a person's height. This can be considered for individuals with a health condition related to height, such as dwarfism, or for individuals experiencing self-confidence issues related to their height.
• Positive impact on self-confidence: Some individuals who have undergone limb lengthening surgery report feeling more comfortable and confident after surgery.
• Convenience in daily and social life: Height length can help some individuals express themselves more comfortably in personal and professional areas.
• Support in movement problems related to leg length discrepancy: In certain medical conditions such as leg length discrepancy, lengthening performed with an appropriate method can help support movement capability.

Possible Disadvantages of Limb Lengthening Surgery

• Cost: Limb lengthening surgery can be an expensive treatment process depending on the method used and duration.
• Process duration: The lengthening process can take several months; during this time, the patient must use an external fixator, which can create some limitation in daily life.
• Pain and discomfort: Limb lengthening surgery is a surgical procedure that can cause pain and discomfort sensations during the healing process.
• Risk of complications: As with any surgical procedure, risks such as infection, nerve damage, blood clot formation, and bone fracture may occur.
• Permanent change: Limb lengthening surgery creates a permanent change in the body; therefore, evaluating all aspects of the process before making a decision is recommended.

Is Limb Lengthening Surgery Painful?

The level of pain felt after limb lengthening surgery varies from person to person. Some factors affecting this variation include:

• The person's pain threshold
• The type of surgery performed
• The scope of the lengthening procedure
• Whether any additional complications are present

Generally, the most intense pain sensation can be experienced in the first days following surgery; over time, this pain tends to decrease, but complete resolution may take weeks or even months.

Some approaches that may help manage post-operative pain:

• Pain medication: Pain relievers deemed appropriate by the physician can help control pain during the healing process.
• Physiotherapy: Physiotherapy sessions can contribute to reducing pain and stiffness, and support the restoration of movement range.
• Ice and heat application: Local ice or heat applications can be used to relieve swelling and pain.
• Leg elevation: Keeping the leg elevated can help reduce swelling and pain.

In summary, limb lengthening surgery is a comprehensive surgical procedure in which bones are cut and gradually separated with the help of a special device, with new bone tissue forming in this gap; therefore, a certain level of pain and discomfort can be expected both during and after surgery and throughout the healing process.

Limb Lengthening Surgery Costs in Turkey

Turkey has managed to gain recognition in limb lengthening surgeries as it has in every field. While serious surgeries performed in Turkey continue to resonate in the international press, foreign patients abroad often make Turkey their first choice.

Extensive hospitals and comfortable healthcare environments, smiling and compassionate healthcare professionals, vacation opportunities in Turkey, and affordable treatment costs are among the reasons for choosing Turkey.

The main items affecting the total cost of limb lengthening surgery include the type of implant/device used, medications and consumables used during and after surgery, necessary imaging and examinations, and the number of physiotherapy sessions administered throughout the process. Since each of these items may vary depending on the patient's condition, chosen method, and treatment duration, accurate cost information can only be determined after physician examination and personalized treatment planning.

If you also wish to have limb lengthening surgery and would like to choose Turkey as your preference, you can contact us for all questions on your mind and detailed pricing information.

Points to Consider When Selecting a Limb Lengthening Clinic

When evaluating a clinic or hospital for limb lengthening surgery, some points to consider include:

• Clinic history and experience: The clinic's experience in this field and the volume of operations it has performed can be researched.
• Surgeon's expertise: It is important to be evaluated by a surgeon experienced and specialized in limb lengthening.
• Physical infrastructure: It can be verified whether the clinic has the equipment and facilities to perform limb lengthening surgery safely and effectively.
• Transparency of treatment plan: The process before, during, and after surgery, possible risks, and care requirements should be clearly shared with the patient.

Sources Consulted:

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https://www.medicalpark.com.tr/boy-uzatma-ameliyati/hg-1985#:~:text=Boy%20uzatma%20ameliyat%C4%B1%2C%20b%C3%BCy%C3%BCme%20plaklar%C4%B1,i%C3%A7in%20yap%C4%B1lan%20bir%20ortopedik%20ameliyatt%C4%B1r.

https://www.leventeralp.com/tr/article/desc/55290/boy-uzatma-ameliyati-nasil-y.html