Legs lengthening

In what cases should be legs lengthened?

There are two main reasons to lengthen legs:

• lengthening the height with cosmetic purpose
• lengthening of the hip or shin due to different diseases

Lengthening the height with cosmetic (aesthetic) purpose

Lengthening of hip or shin with cosmetic purpose is usually 5-8 cm. Such operations are resorted by men as well as women. Average height of patients is 160-180 cm. Such lengthening shouldn't be considered as little more than cosmetic procesdure. Some professions are set with special requirements to human height. For instance, these professions are sports, show business, power structures, security agencies, services agencies etc.

The tallest men was 190 cm before had been lengthend with his legs up to 5 cm.

Hip or shin lengthening in various diseases

There is a range of diseases with the main symptom of small height and disproportion of some segments of continiuties. Achondroplasia is widespread disease. Adult humans suffered from this disease are 120-150 cm. In this case, maximum leg lengthening up to 10-20 cm is rwecommended. This process is expectative, though longlasted.

Correction of different length legs

Different length of legs is one of the most overspread problem in orthopaedics. Every of thuthand human has difference of length legs over than 2 cm. In most cases, this problem is revealed as an incidental finding. First manifestations of congenital shortening are asymptomatic. It may lead to scoliosis formation. Child congenital shortening of legs is connected with different length of low limbs that presumes child medical monitoring during 6-12 months to identify  the retardation of legs growth tempo and to get answers to the following questions:

• operate or not
• at what age to operate
• lenthen the short leg or shorten the long leg
• if lengthen then whan size

Acquired difference in leg length due fracture or growth plate injury needs compensation as soon as possible. There is an misapprehesion that surgeries should be done at the age of 16-18. In cases of significant shortening (more than 3 cm), child should be underwent with surgery at the age of 6-7 to not be handicapped.

Adults real legs shortening is often connected with child diseases or onset disease. As a rule, such "acquirements" are side effects of injuries or operations. Les shortening typically combine with posttraumatic deformations. Adults fit themselves into this pathological condition worse and hit on the idea to have surgery earlier.

What priciple of leg lengthening is based on?

Regardless the specified method of leg lengthening, the general principle is based on Ilizarov invention called "General biological property of tissue is to have growth and regeneration response to extension". I.e. stretching the limb step by step out with the help of Ilizarov apparatus (1 mm per day) allows the muscles, vessels, nerves and skin cover stretch and lengthen progressively without losing its prioperties. This procedure is called osteotomy. The distance of stretched step by step limb is refilled with repaired bone tissue (graft) in the zone of osteotomy bone fragments.

Some think that limb lengthening is a result of some "insertion" to the bone. It is not true. The bone is lengthend by means of newly built bone tissue, which is formed while stretching and gradually  transforms into fully functioned bone that is not different from usual bone by its strength.

At what size to lengthen?

It is naturally, that one would like to lengthen ones legs fast and bigger size. However, organism resources are limited. The taller the initial man's height (respectively his shin and femur length), the more size it can be lengthen. The optimal lengfthening is 5-7 cm.

What method of lengthening to choose?

We use two methods of lengthening:

• Ilizarov classic method. The advantage of this method is a minor injury rate and insignificant post-procedure coplications. Ilizarov method is the most available, safest and proved method of leg correction and its lengthening. It lets not only lengthen, but correct any deformities such as varus and valgus deformities. However, it is needed several months of rigid fixation to bones unite and form the graft. To have on the apparatus is not an easy thing. The disadvantage  of this method is having this apparatus on the leg itself.
• Ilizarov method + intramedullary fixation (express method). We lengthen the shing or femur with the help of Ilizarov apparatus. Along with lengthening, we can fix present deformities. It takes about 1,5-3 months depending on the size of lengthening. Then we remove the apparatus and fix the limb with the intramedullary nail. It helps to return to daily life earlier.

That is why we called this method as an express-method, because it provides the shortest rehabilitation period. Nail fixation (intramedullary osteosynthesis) guaranties rigid stability. The nail itself is inside the bone and has no signs of diturbance unlike the apparatus. So, it is possible to make physical activity in the recent days after operation and start walking in 2-4 weeks without any special means of support and movement.