What is Leg Lengthening Surgery?

What is Leg Lengthening Surgery

When a person’s leg is normal but another one has disarranged with the wrong proportion in the length of 2 inches or more then this procedure is well suited. In some children with the age of 18 or less, height growth stops, particularly for such children Leg lengthening is designed/invented. 

Congenital defects carrying people can undergo this procedure, conditions like Absence of fibula bone, the fibula is a calf bone situated below the knee and above the ankle, Legg Perthes disease, in this condition hip bone prevents its growth due to less blood supply and ends up losing its precise round shape, spasticity, legs become very stiff and fluid movement stops, joint deformities, cerebral palsy, broken bones, and trauma, certain tumours, fractures arise from the growth plate, infectious disease caused due to poliovirus, all these are responsible for shortening the leg. Around 30-60% of people have leg deformities in one way or the other. 

Who Is The Perfect Fit For Leg Lengthening Procedure?

If you have leg skeletal abnormalities then definitely you should consider this surgical treatment. Also, a person with:

• The imbalanced leg which doesn’t align with the entire body 
• One leg shorter than the other
• A Leg missing a segment/component

Causes Of Leg Length Difference 

There numerous things which likely shortens the leg, such as:

• Osteomyelitis 
• Juvenile arthritis
• Gait problems

SYMPTOMS

Usually, this condition shows symptoms like increased uneasiness, pain in the hip, ankle ache, knee jerks, pressurizing toes while walking, running, etc.

Additionally, growth plate injuries also contribute to deforming legs, that include:

1. Sever’s disease – Back heel pain stops the growth of the plate.
2. Patellar Tendonitis – Commonly known as jumper’s knee, weakens the tendon and tears it.

LEG LENGTHENING PROCEDURE

The goal of this surgery is to make leg bone equal, add up to 15 cm of height or the height that matches the undeformed leg, normalize the functioning of muscles and joints, preserve blood supply, quick patient mobilization, and to protect osteogenic tissue. 

As the surgery is time-consuming it can take 2 days to complete the entire procedure. Also, its complexity demands general anaesthesia and sedatives. The duration of the surgery depends on the area to be covered. 

Before the surgery:

To make the procedure more simple preparation prior to the surgery should be done. If the small child is undergoing the surgery then definitely a few arrangements will help him/her in healing. 

• Talk to a physiotherapist as you are going to be needing once you, your child, or any family member comes home after leg lengthening surgery. If you are a working person then hire a caretaker as the patient will require help in dressing, bathing, etc. If the patient is in school or college then also arrange a teacher who can help in studies. Buy wheelchair, crutches, and walker.
• Give all the medicines that are prescribed by the surgeon during the first appointment. Stop alcohol and smoking.

During the surgery:

An orthopaedic surgeon with the team starts a procedure with anaesthesia to make patient numb throughout the process. The duration of surgery relies on bone modification. 

ILIZAROV TECHNIQUE 

The cut will be made where the lengthening of bone is required, typically somewhere around the tibia and femur. Metals, physical staples, intramedullary nails, and screws will be needed during the process. In the peripheral area of the cut, pins will be added. With the help of wires and pins, an external fixator will be connected with the surgical bone. Helps the growth of mature and undeformed bone. External fixator mainly helps with the fractured bones to put them in an aligned manner as its primary function. It is also known as Ilizarov external and its shape is like a ring.  After reaching the exact length, a procedure to extract the pins or wires will be done. 

WAGNER TECHNIQUE

This technique is also known as smooth pin fixation this requires bone grafting and another surgery is done to remove the plate. 3 or more surgeries are needed during this procedure.

After the surgery:

The patient will need to stay at the hospital for 5 days if the Ilizarov method is used and 8 days if the wanger’s method is used. Cast or a shell made with fibreglass or plaster is used to add strength, support, and stability to the leg, the doctor keeps it attached to the leg for a month or two. 

POTENTIAL COMPLICATIONS

Apart from surgical complications, anaesthesia and sedative complications also hit the patient.

• Nerve injury affects the bone leg after surgery
• The pin doesn’t hold its tightness over the time
• Possible defects in any one leg if the surgery is done both the legs
• Fault in blood vessels
• Injury in cartilage

Other possible complications are vascular damage, blood clotting, delayed bone healing, faults in internal and external fixators, compartment syndrome, slip progression destruction, allergies due to medications, complications due to anaesthesia ( dizziness, nausea, headache and vomiting), unsuccessful epiphysiodesis and joint tightness.

DIAGNOSIS OF LEG LENGTH DISCREPANCY

Doctors first dig the patient’s medical history and inspection of legs colour, consistency size and shape which gives them the status of your overall health, especially legs health, through this variation in leg’s length can also be known.

Then they conduct a physical examination that involves observing the way patient walks. A patient can be seen walking by keeping pressure on toes or curves the normal leg while walking. A doctor puts wooden block under the wooden leg to align both the hips, tests such as :

1. X-ray – It can help the doctor to view inside of your leg without making any cuts in the body. The doctor will monitor whether a patient is suffering from osteoporosis or not. This test is performed by a radiologist to get the clean images of your leg, guidance will be given to you. The results of x-ray of your leg/legs will be given to you on the same day or next day. 
2. CT scan – A computerized tomography scan uses a computer and rotating x-ray machine to form cross-sectional images of the leg, helps to show blood vessels, soft tissues and bones of leg closely, You will lie in a tunnel/rubber tube resembling machine while the inside of the machine rotates and takes a series of X-rays from different angles. 3D images can also be taken from this.
3. MRI scan, bone scan, ultrasonography, iliopsoas-tendinopathy are also performed  

All these tests are very useful in measuring the length and density of bones. 

COST OF LEG LENGTHENING

Cost of leg-lengthening in India is around 1,50,000 rupees to 2,50,000 rupees. Insurance may cover the cost of either procedure, especially if your doctor determines the bone length differences is causing significant impairment. However, it’s advisable that you call your health insurance company to verify coverage before undertaking the procedure so you don’t have any surprise bills.

EXERCISES FOR LEG LENGTHENING

For some people, to pay tens of thousands of dollars or lakhs of rupees for leg lengthening treatment isn’t an affordable option, such people can first of all try with exercises after having a deep discussion with doctor/surgeon about the same.

Suppose, your left leg is small then sit on the floor or bed with the left leg in front of you bent at 90 degree or right angle and keep your knee and ankle on floor or bed align your knee and hip with your entire leg. Another exercise is a side plank.

After surgery exercises

Go out for walking ( start with a small distance and then slowly increase the speed), while going out for walking after leg lengthening surgery make sure you have someone stronger than you as a companion. 

HOSPITALS AND DOCTORS FOR LEG-LENGTHENING

Below mentioned hospitals which Anavara suggests are above and beyond when it comes to leg-lengthening surgery. Their goal is to provide an innovative and holistic approach to minimally invasive surgical care. For hospitals to discover, Thumbay, Maharaja Agrasen, Glean Eagles, Columbia Asia and KIMS. 

Even you can check the skilled and experienced doctors/surgeons also, Dr Sanyukta Banerjee, Dr. Raghunathan and Dr V.J. Laheri. 

FAQs:

 

• What’s the success rate of leg lengthening surgery?

The success rate of leg lengthening surgery is more than 90%, people noticed ample benefits after the surgery, so yeah, it is highly recommended.

• What is the recovery period after leg lengthening surgery?

It usually depends on the age and portion of the surgery, but still, on an average, it takes 2-3 months for healing. 

• Does leg lengthening surgery hurt?

Yes, but not during the surgery, you will experience pain after the surgery as a number of pins, screws, wires and staples are added pain is very obvious, but pain relievers are very useful during the healing process, it reduces the pain, so don’t skip taking it.