Limb lengthening and reconstruction surgery is a specialized procedure that can help improve the function and appearance of limbs that have been affected by a variety of conditions. These conditions may include:
Leg Length Discrepancy (LLD)
Treatment goals are to correct the LLD while preserving muscle and join functions and restoring normal limb alignment.
Post-traumatic Bone deformity
Traumatic fractures that heal in displaced, angulated, rotated, or shortened positions.
Non/malunions
Nonunion are unhealing fractures, malunion are incorrectly healed fractures.
Bone loss from tumour, trauma, or infection
Bone loss may be a bone defect or as limb length discrepancy or both.
Joint contractures
Limited movement of tight muscles or capsules or scarring of the joint.
Osteomyelitis
Results from fractures or blood borne infection. An effective solution is to resect the abnormal bone and use Ilizarov technique to treat bone defect.
The surgery can be performed on people of all ages, and it can be a life-changing procedure for those who have been struggling with the limitations caused by their condition.
The Process of Limb Lengthening and Reconstruction Surgery
The process of limb lengthening and reconstruction surgery typically involves several steps:
Preoperative consultation: During this consultation, the surgeon will discuss your medical history, your condition, and your goals for surgery. They will also perform a physical examination and may order imaging tests, such as X-rays or CT scans.
The surgical procedure: The specific details of the surgical procedure will vary depending on the individual patient's needs. However, in general, the surgery will involve making an incision in the leg, and then inserting a device that will gradually lengthen the bone. The device will be adjusted over time, and the bone will slowly grow new bone tissue to fill in the gap.
Post-operative care: In a standard patient, they must remain in hospital for 3-7 days before discharge. Following there is the adjustment and consolidation phase. The adjustment phase is split to 2 further phases:
Latent Phase:
For restoration of endosteal and periosteal blood vessels
Distraction Phase:
1mm/day until desired length is achieved.
After the desired length is achieved and the limb is straightened, the apparatus is left for the consolidation phase which allows the bone to harden and mature. Once the bone is sufficiently strong, the frame can be removed. The patient is seen every month within these phases once the frame is off with no complications the patient can then have follow-up appointments to the discretion of the Doctor.
Potential Complications of Limb Lengthening and Reconstruction Surgery
As with any surgery, there are potential complications associated with limb lengthening and reconstruction surgery. These complications may include:
Anaesthetic complications
Infection
Deep infections are rare; however, pin tract infections are common but easily treated with pin tract cleaning and oral antibiotics.
DVT/Pulmonary Embolus
DVT is a clot in the leg that can break off to the lung to where it is called pulmonary embolus. Number of precautions are taken, including using a blood thinner called Clexane and the patient is to be blood tested regularly until clear.
Nerve/Blood Vessel injury
Despite being extremely rare, still must account for the risk. Injury of the nerve can cause momentary/permanent partial or total loss of function. Blood vessel injuries may cause significant blood loss, leading to ischemia of a limb.
Non/Malunion
Poor bone formation can lead to nonunion, where the bone fails to heal. But when the bone heals in an unsatisfactory position, that is malunion.
Fracture/Late deformity
May happen due to removal of the frame being too early
Over/Underlengthening
Possible, but very rare due to the Doctor being in control of this
CRPS
The nerves act hyper actively and sensitively. Characterised by severe pain, swelling, and stiffness. Unpredictable in nature unless there is prior history.
Loss of function
Reference: O’Carrigan, T. (2016, August 1). Limb Lengthening and Reconstruction. Limb Reconstruction Service NSW. https://www.timocarrigan.com.au/limb-lengthening-and-reconstruction-specialist-orthopaedic-surgeon-campbelltown-nsw.html
Disclaimer: This blog is for informational purposes only and should not be considered medical advice. Please consult with your healthcare provider for any questions or concerns regarding your individual health.