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Limb lengthening involves the lengthening of the bones in the legs and arms. This is done slowly so that bones and soft tissues (skin. muscles. nerves. etc.) are gradually increased in length. Slowly, the length will increase. This process usually takes several months. Combining limb lengthening with acute or gradual deformity correction can also be done. We routinely lengthen the humerus, radius/ulna and metatarsals at the International Center for Limb Lengthening. These bones affect the toe length.
What does it take to lengthen limbs?
Two separate pieces of bone will be created by surgery. Osteotomy is the surgical procedure used to remove a bone. To prepare muscles and nerves to lengthen, additional soft-tissue operations may be required. To facilitate a tibial (shinbone), lengthening, it is possible to surgically lengthen the Achilles tendon. An orthopedic lengthening device will be applied by the doctor to the bone. Implanted orthopedic lengthening devices are known as internal devices. The Precice nail, for example, is one such device. The Taylor Spatial Frame, or the Ilizarov device are external fixators.
To speed up the healing process, the bones must be allowed to rest after surgery. The latency time is also known as the healing period. After the latency period is over, the patient will adjust their orthopedic device so that it gradually separates the two bone segments. This gradual separation of the two bone segments is called "distraction" which literally means "pulling apart". New bone forms as the bone fragments are gradually pulled apart. This new bone expands the bone's length. The new bone is called regenerate bones.
During the distraction phase, the patient or family member adjusts their orthopedic device daily so that the bone segments are being pulled apart at a slow pace of about 1 mm (0.04 inches) per days. The rate of disintegration may vary slightly depending on the bone. One example is to distract 0.75 mm daily in the tibia but 1.0 mm per days in the hips or femur. This gradual distraction causes the body to continuously grow new bone and soft tissue, such as skin, muscle, nerves, blood vessels, and muscles. The bone will reach the desired length after the distraction phase ends. Each month, the bone can grow approximately 1 inch (2.5cm) in length. During the distraction phase, the patient will need several visits to the doctor to ensure that the bone isn't growing too fast or too slowly. The doctor can speed up or slow down distraction depending on how the bone regenerates on X-rays. The patient will need to go to physical therapy between two and five times per week to distract from the distraction process.
Following the distraction phase is the consolidation phase where the regeneration bone slowly hardens. For a 5-cm (2 inch) lengthening, it takes approximately 2 months to reach the desired length. Then it takes 2 to 3 additional months for the bone to harden. In this case, the lengthening device will stay in place for between 4 and 5 months. The "healing" of the new bone will only occur after the calcified, hardened bone has calcified. Patients should stop smoking, avoid any nicotine, and eat a healthy diet that includes lots of protein. Vitamin and mineral supplements are also recommended to aid bone healing. During consolidation, the doctor will tell the patient to put some weight on the arm/leg with the help of crutches and a walker. This will increase bone hardening and healing. At the end, patients can cease using crutches.
The orthopedic lengthening devices can be removed from the patient's body after the bone has fully consolidated. Patients are typically not required to stay overnight at the hospital following surgery. A cast or brace may be applied to protect the bone after surgery. No cast or splint are required when an internal device has been removed following the lengthening of a bone.
Limb Lengthening Surgery Cost in India
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