Limb Lengthening
How Does Limb Lengthening Work?
Limb lengthening works through a process called distraction osteogenesis. During treatment, bone and surrounding soft tissues are gradually separated at a slow, controlled rate so the body can form new bone in the gap.
The process generally includes:
- Surgery: The bone is carefully cut in a controlled way.
- Latency phase: The body begins the early healing response before lengthening starts.
- Distraction phase: The bone is gradually lengthened. The rate is often about 1 millimeter per day, although the plan may vary based on the patient, bone, device and healing response.
- Consolidation phase: The new bone hardens and strengthens after the desired length is reached.
Moving too quickly may affect bone formation or soft tissues. Moving too slowly may allow the bone to heal too early, a process called premature consolidation. Close follow-up is important so the care team can monitor bone growth, alignment, joints, nerves, muscles and overall function.
Who May Be a Candidate for Limb Lengthening?
A patient may be considered for limb lengthening when a limb length difference, congenital limb condition, skeletal dysplasia or injury-related shortening affects function, alignment or treatment goals.
A physician may evaluate:
The Paley Approach
Limb lengthening and limb deformity correction require careful surgical planning, close follow-up and rehabilitation. The goal is not only to gain length, but also to protect alignment, joint motion, muscle function and the patient’s ability to move comfortably.
The results of limb lengthening can depend on surgical experience, follow-up care and early management of complications. Patients and families are guided through each phase of treatment so concerns can be addressed promptly.
At the Paley Institute in Palm Beach County, FL, treatment planning may include:
The Alternative to Amputation
Dr. Paley has developed operative procedures for bone and soft-tissue reconstruction of congenital, developmental and post-traumatic limb disorders. He has also reclassified many of the diagnoses he treats, shifting emphasis from amputation and prosthetic fitting to reconstructive techniques.
Dr. Paley’s approach to treatment goes in two directions: to develop and improve both procedures and devices in order to offer treatment options for patients with complex limb conditions.
Research and Treatment Innovation
Dr. Paley has published peer-reviewed articles, authored and edited books and contributed to research in limb deformity correction and reconstruction. His textbook, Principles of Deformity Correction, focuses on the analysis, planning and treatment methods used in limb deformity care.
Conditions Treated With Limb Lengthening and Deformity Correction
Dr. Paley has pioneered the treatment of many complex orthopedic conditions. His advances in the treatment of congenital deformities have given children who would have otherwise lost their legs, excellent function without the need for prosthesis. Dr. Paley has developed many specific surgical therapeutics for different uncommon and rare diseases in children and adults for both the upper and lower limbs. Some of his ground-breaking work has been in the treatment of:
Congenital Limb Differences
Skeletal Dysplasias and Growth-Related Conditions
Hip, Wrist and Other Orthopedic Conditions
Treating Limb Lengthening Complications
There are potential complications with limb lengthening surgery, which is why careful follow-up is an essential part of treatment. Some complications may be managed without surgery, while others may require an additional procedure.
Complications are treated promptly and carefully to help protect function and reduce the chance of lasting problems. This is one reason the experience of the care team matters throughout the entire lengthening process, not only during the surgery itself.
Limb Lengthening Resources
Extramedullary Internal Limb Lengthening
Learn about Extramedullary Internal Limb Lengthening a paper written by Claire Shannon, MD and Dror Paley, MD, FRCSC
