Limb Lengthening
What is limb lengthening surgery?
Limb lengthening surgery is a specialized orthopedic procedure used to correct shortening in the arms or legs. It is performed in patients who have:
Limb length discrepancy due to trauma or congenital conditions,
Or those who wish to increase their height for cosmetic reasons.
Factors such as smoking, alcohol consumption, and antidepressant use can negatively affect bone healing during this process. Therefore, we carefully evaluate each patient’s lifestyle and medical history before proceeding with treatment.
Several surgical techniques are available, but they all follow the same biological principle:
- The target bone is surgically cut (osteotomy).
- After a 1-week latency period, gradual lengthening begins at a rate of 1 mm per day (typically divided into 4 increments of 0.25 mm).
- Once the desired length is achieved, the device is locked, and the new bone is allowed to consolidate (harden).
The total treatment duration depends on the amount of lengthening—consolidation usually takes about twice as long as the lengthening phase. Regular follow-up X-rays are essential to monitor bone formation and determine when the external or internal device can be removed.
What are the limb lengthening methods?
1. Circular External Fixator (Ilizarov Method)
After osteotomy, a ring-shaped external frame is mounted around the limb (360° support). The patient adjusts the device four times daily, turning a calibrated nut by one-quarter turn each time to achieve 1 mm of daily lengthening.
2. Combined Technique (LON – Lengthening Over Nail)
In this method, an intramedullary nail is inserted into the bone after osteotomy, and a monolateral external fixator is attached from outside. Lengthening is performed the same way—1 mm per day via four 0.25-mm adjustments. Once the target length is reached, the nail is locked, and the external fixator is removed. The intramedullary nail remains in place until bone consolidation is complete.
3. Magnetic Intramedullary Nail (PRECICE System)
This advanced technique uses a telescopic magnetic nail implanted inside the bone—no external frame is needed. Lengthening is controlled externally using a handheld magnetic remote placed over the leg. The patient activates the device according to the prescribed schedule to achieve precise daily lengthening.
There are two generations of magnetic nails:
- First-generation: Requires strict non-weight-bearing to protect the internal gear mechanism.
- Second-generation (e.g., PRECICE 2.2): Allows full weight-bearing and walking during lengthening, significantly improving patient comfort and mobility.
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"These contents have been prepared by Prof. Dr. Halil Burç based on over 25 years of clinical experience."