Limb lengthening surgery is a surgical operation that some people undergo for medical reasons (such as dwarfism or having one leg shorter than the other) while others opt for purely cosmetic reasons. Nowadays, to achieve height increase, doctors first request various tests from the patients, and then they decide whether the patient is suitable for surgery and, if so, which method should be used. As a result of these examinations and tests, it becomes clear how many centimeters it’s possible to increase your height, which method will be used for the surgery, or whether you’re suitable for the surgery at all. If you want to delve deeper into the methods used in limb lengthening surgery, you can check out our article titled “methods of limb lengthening surgery.”
When it comes to the post operative process of limb lengthening surgery, there are multiple points that need to be known and considered.
Early Post-op Period (Latency Period)
The initial post-operative period in limb lengthening does indeed begin once the surgery is completed and lasts until the start of the distraction phase. The distraction phase refers to the period when the bone is gradually pulled apart to allow new bone formation in the created gap. In this phase, there are some crucial points that you should be careful:
- Pin Site Care: If an external fixator is used (like in the Ilizarov method), pin site care is crucial. The pins go through the skin and attach to the bone, which means they provide a potential entry point for infections. Cleaning the area around the pin sites is a standard procedure to prevent infections.
- Signs of Infection: Warmth, redness, and swelling around the pin site can indeed be early signs of an infection. It’s essential for patients to recognize these symptoms and act promptly.
- Antibiotic Use: If there are signs of a pin site infection, particularly if there’s purulent discharge, it’s standard procedure to initiate antibiotics after consultation with a healthcare professional.
Following a latency period of approximately 7-10 days post-surgery, the bone’s lengthening process begins. By this point, patients should be familiar with the correct operation of the device. Typically, bones are lengthened at a rate between 0.5 and 1 mm daily, though this can be adjusted based on the doctor’s recommendations and the patient’s progress.
It is true that many complications related to limb lengthening can occur during the distraction phase. This is because it’s the active phase when the bone is being gradually separated and new bone is forming. Regular visits, such as every two weeks, are common during the distraction phase to monitor progress and any complications. These visits often include physical examinations and X-ray studies. Patients residing outside the local area have the option to submit their X-rays and physical therapy updates electronically rather than visiting in person. Once the doctor examines the X-rays, they will either communicate with the patient via email or through a virtual consultation. During this interaction, the doctor provides updated guidelines on weight-bearing, especially if the patient underwent a procedure using the intramedullary nailing system. Additionally, any concerns or issues the patient might have are addressed.
Once the bone has been extended to the desired length, the newly formed callus (which is called “Regenerate) requires a period to strengthen and transform into regular bone capable of supporting weight. This is the phase where the newly formed bone in the gap hardens and matures and is known as “consolidation.”
The external fixator stays in place throughout the consolidation phase, ensuring the newly formed bone solidifies. It’s essential for the new bone to be strong and mature before the fixator is removed to ensure the limb can bear weight and function properly. The consolidation phase’s duration can vary but is usually longer than the distraction phase. Factors influencing its duration include the patient’s age, overall health, the quality of the new bone formed, nutrition, and other associated medical conditions.
Before taking off the support frame, patients might have a ‘test’. This means they’ll try to use their limb without some parts of the frame. For legs, this involves standing or walking; for arms, it’s about doing everyday tasks. If the patient can do these things well, it’s safe to remove the frame. Taking off the frame is usually done with the patient anesthesia because removing certain parts can be painful.
During the consolidation phase, if you have a Precice Nail, you will continue to walk with weight bearing restrictions. No more alterations will be made to the PRECICE nail. The PRECICE nail will remain in place throughout the consolidation phase to support the regenerate bone. Depending on the bone that has been lengthened, the length of the regenerate and individual parameters of the patient, full weight bearing is usually allowed between 6 and 8 weeks after the end of the lengthening phase. The implantable device should be removed to prevent materials from rusting over time. Doctors usually suggest taking it out 1 to 2 years after putting it in, but there’s no rush. Removal of implanted metal devices requires another surgical procedure under general anesthesia.
During the consolidation phase, there’s a significant drop in the risk of complications, and the patient starts to function better. Several factors impact how the bone heals: the patient’s age, which bone segment (like the femur or tibia) is involved, where the cut for lengthening was made, and the size of the gap created for distraction. For instance, the femur tends to heal faster than the tibia during lengthening. Age is also a factor: people under 20 years heal quicker than those between 20 and 29 years. Meanwhile, those above 30 years heal the slowest.
Lengthening over Nail (LON Method)
There’s an approach to shorten the time a patient wears an external fixator. This involves inserting a solid nail inside the bone when the lengthening cut is made. Once the lengthening (or distraction) phase is over, the nail is secured to maintain the new bone length and position, allowing for the external device to be taken off.
After limb lengthening surgery, one of the most crucial aspects to ensure a healthy and rapid recovery is not to skip physiotherapy sessions. Although the frequency of these sessions may vary depending on the surgical method used, every patient should attend them as recommended by their doctor.
Neglecting to attend physiotherapy sessions or not following your doctor’s recommendations can lead to complications in your recovery process. Therefore, after the surgery, it’s important to remember that the process may require additional treatments. You can look into our Youtube page to gain much information about physiotherapy sessions and other patients’ interviews.
Possible Complications and Risks After Limb Lengthening Surgery
After limb lengthening surgery, one of the most crucial points to consider is the regular dressing and cleaning of the surgical areas. Hygiene is one of the most important factors for this process. Neglecting regular dressing can lead to permanent scar marks, and failing to disinfect the wounded area consistently can increase the risk of infection.
Additionally, skipping physiotherapy sessions can weaken the muscles in the leg, slowing down the recovery process. Therefore, it’s vital not to miss doctor’s appointments and to continue all necessary treatments after the surgery. If you’re curious about the potential complications and risks that might arise after the surgery and under what conditions they might occur, you can read our article titled “Possible Complications After Limb Lengthening Surgery” for more details.
For More Information:
If you would like to get more detailed information about the surgery or ask any questions you have in mind, you can directly contact our patient representatives to obtain comprehensive information. Additionally, you can follow us on social media accounts like Instagram and TikTok to both stay updated with our latest announcements and closely monitor the surgical processes of our patients.