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Limb Lengthening

Limb lengthening is generally done with the help of an internal lengthening device. This surgery is generally done in people with a discrepancy in the leg length. The lengthening device is generally in the form of a rod that is placed inside a bone. A magnetic gear system inside the rod works with the handheld remote controller which is placed on the top of the skin using another magnet to slowly lengthen the internal device. The child would receive general anaesthesia to help sleep through the surgery. The incision is made through the skin and the device is inserted into the bone. Another incision helps to cut the bone for further growth.

Lengthening over nail
The limb lengthening with the Ilizarov technique is quite safe and is known to be a successful surgical procedure. The biological principles in this process are very well understood. The consolidation phase would take twice as long as the distraction phase, during which the patients grow weary of the fixator and demand for its removal. The fixator must stay in place until the corticles are properly formed. The lengthening takes place with the help of an intramedullary nail which is locked at the increased length. The method is quite effective and does rarely fail to achieve the desired goals.

Lengthening over plate
Using the plate removes the associated risk of infection that might be there with the procedure concerning the intramedullary nail. The risk of deep intramedullary infection is removed. This procedure can be performed in patients of any age group. The procedure uses multiple drill holes and osteotome. The corticotomy is performed through the same incision made for sliding the plate. Fixing the plate before the osteotomy would provide stability to the fragments and make the procedure much easier. The complications can be avoided if the patients do not put weight after the fixator has been removed. The procedure is quite suitable for most patients.

Internal lengthening nails
This procedure is very useful in the cases of lengthening of the femur. deformities can also be cured with a retrograde approach. The healing rate achieved with this technique is phenomenal. This type of lengthening surgery is becoming popular in recent days. Much more scientific information is available on these processes. However, failures might occur if the femur is overly loaded in times when the bone is growing through a vulnerable growth phase. The cost might be a little higher than the other surgical procedures. However, the number of surgeries is reduced if it is compared to the lengthening-over-nail technique, which is the gold standard today.

Limb reservation prostheses
The prostheses available today are much more functional and comfortable. With motivation, people can accomplish extraordinary feats. The prostheses can offer great psychological benefits, depending on a few factors:

• the stability, fitness and comfort of the prostheses
• the type of socket and components used in the prostheses
• the goal of the user, the health, age and mental stability

The success of working with the prostheses depends on how the doctor and the clinical team works with the patient to determine the best possible fit and the most appropriate type of prosthesis.

Thus the limb lengthening surgery, though the same at heart, can be performed with different procedures. The type should be selected after prolonged discussions with the doctor or medical professionals.

Authored By: Dr. S. V. Santpure