What is Limb Lengthening Surgery?

Humans are beings that are constantly developing and changing. They grow, develop, and differentiate through different stages of development from infancy to childhood. Each stage has its own unique parameters for growth and development. From infancy, basic needs such as nutrition and shelter must be met by parents. Meeting these basic needs during a child's growth and development ensures that they go through their current stage healthily and that the characteristics of the next stage of development are age-appropriate.

Nutrients are fundamental elements that support the body's growth and development. Proper and age-appropriate nutrition from infancy to childhood ensures that growth and development are aligned with the current stage.

The first introduction to food groups begins with breast milk. Breast milk contains all the nutritional components that a baby needs. It is essential not to neglect breast milk from the very first moments after birth. It should be supplemented with appropriate solid foods at the right times, and breast milk is typically discontinued based on a doctor's recommendation according to the baby's developmental stage. When breastfeeding is stopped, incorporating the right food groups into the baby's diet helps ensure that their growth and development continue healthily. A balanced intake of carbohydrates, proteins, fats, vitamins, and minerals in the nutrition program is important for appropriate growth and development. Healthy weight gain, teething, bone development, and height increase are all related to the nutrition patterns established from infancy through childhood. Spending this period with quality food groups supports growth and development, ensuring that height increase is appropriate for the stage.

Conditions that negatively affect growth and development before and after birth can lead to short stature. Individuals who do not reach the desired height may turn to methods such as limb lengthening surgery.

What is Limb Lengthening Surgery?

Genetic factors, maternal smoking during pregnancy, lack of breastfeeding after birth, insufficient nutrition during the complementary feeding period, and certain illnesses can cause a person to be shorter than the desired height. Limb lengthening methods are used when an individual's height does not fall within the required range for their age and gender or when they desire to be taller than their current height. Limb lengthening surgery is also performed in cases where one leg is shorter than the other.

The limb lengthening surgery involves a slow and controlled process, usually taking weeks. This procedure allows the gradual lengthening of leg bones such as the femur (thigh bone) and tibia (shin bone), as well as soft tissues like muscles, skin, and nerves. In the surgery, the tibia and femur are lengthened. If deemed appropriate by the doctor, both bones can be lengthened. The procedure consists of four main stages: surgical application, postoperative rest and observation, initiation of bone lengthening, and the healing process as the bones grow and harden. General anesthesia is administered prior to the surgical procedure. During the postoperative resting period, the bones are allowed to rest for 5-7 days, and no external bone lengthening is performed. In the next phase, an external fixator is used to separate the two bone segments and initiate the bone lengthening process. The lengthening procedure continues daily until the bones reach the desired length. Regular physical therapy and recommended exercises during the lengthening phase help maintain bone strength and mobility. The final stage, where the bone grows and hardens, occurs with calcium accumulation in the new bone structure. At this stage, the doctor recommends weight-bearing and walking to strengthen the new bone. Additionally, it is crucial to pay attention to balanced nutrition and follow a diet rich in protein, vitamins, and minerals to enhance bone strength.

In limb lengthening surgery, the bone to be lengthened is divided into two parts. An orthopedic limb lengthening device is inserted to facilitate the lengthening process. There are two types of devices used in limb lengthening:

• Internal Device: An orthopedic limb lengthening method that involves placing a device inside the bone. The inserted device can be controlled externally. One of the internal devices used for precise lengthening is the precision nail.
• External Fixator: This method uses an external limb lengthening device and is known as an external method.

Structures that support the bone, such as muscles and nerves, are also addressed during limb lengthening surgery. For example, the Achilles tendon is also lengthened to support a lengthening procedure performed on the shinbone.

Why is Limb Lengthening Surgery Performed?

Certain medical conditions can affect the growth and development of limbs. Polio, cerebral palsy, which affects posture and movement, birth defects affecting bones, joints, muscles, tendons, and ligaments, hip disorders such as Legg-Calvé-Perthes disease, short, weak, and tight muscles, injuries, and bone fractures can all impact growth and development, preventing limbs from reaching the required length. Limb lengthening surgery is performed when limbs do not achieve the desired length or equality. Some conditions in which limb lengthening surgery is applied include:

• Children whose bones are still growing
• Children with issues in their growth plates
• Adults who are short or wish to add a few centimeters to their height
• Individuals who have experienced physical injuries that have shortened or lengthened their limbs.

How Much Does Limb Lengthening Surgery Affect Height?

Limb lengthening surgery can achieve an increase in height of up to 15 cm. The typical increase after a single surgery is about 2 cm. If the individual desires it and the doctor deems it appropriate, surgeries can be repeated at certain intervals to facilitate further bone lengthening.

What Are the Risks of Limb Lengthening Surgery?

Limb lengthening surgery involves specific procedures both before and after the operation, and the healing process takes time. There are certain risks associated with the surgery, which depend on the course of the operation, the healthy management of the postoperative period, and the individual's genetic characteristics. These risks include:

• Infection at the injection site
• Joint dislocation
• Damage to blood vessels
• Infection in the bones
• Muscle contractions
• Nerve damage
• Bones forming too early or too late
• Bones not fusing together

Monitoring after limb lengthening surgery is important to detect and manage potential side effects early. Changes in skin color and sudden fluctuations in body temperature should be observed during the postoperative process. The recovery period following limb lengthening surgery varies from person to person. For example, individuals with diabetes or those who smoke may experience slower bone growth.

What Is the Recovery Time After Limb Lengthening Surgery?

The recovery time after limb lengthening surgery varies depending on the individual and the procedure performed. The absence of any underlying health conditions, having a strong musculoskeletal system, and not having harmful habits can accelerate the recovery process. Additionally, the extent of bone lengthening and the number of surgeries also affect recovery time. Bones that are lengthened to a lesser degree typically heal faster postoperatively, while an increased number of surgeries and greater desired lengthening delay the recovery process.

Bone healing occurs faster in children compared to adults. After the bone reaches the desired length, the healing process begins to accelerate. Generally, walking without crutches can begin within 2-3 months after the surgery.

Health is a significant concept that affects human life. Developments in health technologies today enable people to lead a higher quality of life. Regular visits to the hospital for check-ups and timely tests are essential for the prevention of diseases and early treatment. By regularly undergoing health checks, you can prevent undesirable conditions and continue your life in a higher quality.